Sleep Studies: Protocol and Implementation Guide

A Comprehensive Guide for Sleep Laboratory Procedures

Neurology

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Last updated: Mar 24, 2025

Overview

This protocol outlines standard procedures for conducting polysomnography (PSG) and other sleep studies in clinical settings.

Pre-Study Procedures

Patient Preparation

  1. Verify patient eligibility and prescreening documentation
  2. Confirm medication status and recent caffeine intake
  3. Review sleep diary (minimum 2 weeks of data)

Technical Setup

  • Calibrate all monitoring equipment
  • Verify electrode impedances (<5kΩ)
  • Test recording systems

Standard Monitoring Parameters

Required Measurements

  • EEG (minimum leads: F4-M1, C4-M1, O2-M1)
  • EOG (right and left)
  • Chin EMG
  • ECG
  • Airflow (nasal and oral)
  • Respiratory effort (thoracic and abdominal)
  • Oxygen saturation
  • Body position
  • Leg EMG

Recording Protocol

Montage Application

  1. Clean and prepare skin surfaces
  2. Apply electrodes following 10-20 system
  3. Perform bio-calibrations

Study Duration

  • Minimum 6 hours of recording
  • Lights out between 21:00-23:00
  • Morning awakening between 06:00-08:00

Data Analysis

Scoring Parameters

  • Score in 30-second epochs
  • Follow AASM scoring guidelines
  • Document artifacts and technical issues

Required Measurements

  1. Total Sleep Time (TST)
  2. Sleep Efficiency
  3. Sleep Latency
  4. REM Latency
  5. Arousal Index

Quality Assurance

Technical Review

  • Signal quality assessment
  • Artifact identification
  • Data validation

Clinical Review

  • Scoring verification
  • Clinical correlation
  • Final report generation

Emergency Procedures

Medical Emergencies

  1. Emergency contact protocols
  2. Equipment for basic life support
  3. Emergency response documentation

Documentation Requirements

Essential Forms

  • Patient consent
  • Technical worksheet
  • Sleep questionnaires
  • Final report template

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