Sleep Studies and Co-morbidities
The increase in sleep awareness has lead to more PSGs performed on patients with co-morbid conditions. We recently saw a COPD patient having an exacerbation and a patient with a mental disorder and possible seizures as well as several patients with anxiety and depressive disorders. All these patients required a great deal of skill by the technician to care for them and handle their unique situations.
The patient with COPD came in very short of breath. The physician was informed and the technician proceeded with the study. This patient required close attention to his oxygen saturation and his ventilation. The technician was excellent, titrating the oxygen at half a liter at a time. The patient was also propped up slightly for comfort and to help reduce some of the work of breathing. In the end, we did have a successful sleep study for the physician.
The seizure patient was followed very closely, and in the morning, the ordering physician sent the patient to a neurologist for follow up. This was due to the scoring technician following up with this doctor and discussing the possible situation. This patient couldn't communicate due to his mental status, which may be why the family did not notice the problem. In the end, the patient received the help he needed and will be restudied in the future to find if he truly has sleep apnea or if it was an effect of the brain activity.
Also, in our area, it appears many psychiatrists find they can reduce medication if they treat the patients' sleep apnea. People with anxiety and depressive disorders require understanding and a personal touch. This is where every technician in my lab excels. Taking the time to desensitize the patient to the mask, trial multiple masks, and listen to the patient's worries and concerns go a long way to making a successful titration study as well as a much more compliant patient.