Sleep Laboratory

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Sleep Laboratory

The sleep laboratory is a service that requires a multidisciplinary approach involving specialists in neurology, ENT (Ear, Nose, and Throat), pulmonology, and psychiatry. This responsibility is carried out with this awareness.

In the sleep laboratory, the patient is allowed to fall asleep naturally while the necessary recordings are made. After the patient wakes up, these recordings are evaluated. A definitive diagnosis of sleep disorders can only be made in sleep laboratories specially equipped for this purpose. However, not everyone with sleep complaints may have a problem that can be confirmed in a laboratory setting. In addition, tests performed on some individuals without obvious symptoms may reveal pathological findings.

Our sleep laboratory is equipped with two sleep rooms, a phototherapy room, a sleep deprivation room, and a centralized digital monitoring system.

Tests Conducted in Sleep Laboratories

The following recordings are made using the polysomnography method in sleep laboratories:

• EEG (Electroencephalography)
• Eye movements (EOG = Electrooculography)
• Jaw EMG (Electromyography)
• Respiratory recordings (airflow, chest and abdominal muscle movements, pulse oximetry)
• ECG (Electrocardiography)
• Leg EMG

Based on these recordings, sleep stages are determined and a detailed sleep study is conducted.

If a multidisciplinary approach is not taken into account throughout the treatment, it becomes difficult to speak of a realistic treatment; because careful examination and treatment planning by multiple specialties are required to get to the root of the problem causing this condition. In addition to all of this, a psychiatric approach is often necessary in treatment.

When Should You Visit a Sleep Lab?

If you are considering visiting a sleep laboratory, you may be experiencing chronic insomnia or sleep attacks.

You should visit a sleep lab in the following situations:

• If you cannot sleep at all,
• If you’re sleeping excessively and have difficulty waking up, which is negatively affecting your social life,
• If you wake up constantly during the night,
• If you fall asleep even while sitting,
• If you don’t feel rested even after sleeping a lot and still feel tired,
• If you wake up with a start,
• If you have very bad nightmares or disturbing dreams.

These symptoms can further impair your quality of life if left untreated. Therefore, it’s important to seek help from a sleep lab if you’re experiencing these types of sleep problems.

How Can You Tell If You Have a Sleep Problem?

Sleep problems can lead to serious health issues that negatively impact your daily quality of life. Sleep-related problems manifest as follows:

• If it takes you more than 20 minutes to fall asleep at night,
• If you fall asleep immediately but wake up very frequently,
• If you wake up very early and cannot fall back asleep,
• If all these symptoms last longer than two weeks,
• If your breathing pauses while you’re asleep,
• If you have trouble breathing or feel short of breath when you wake up,
• If you snore loudly and irregularly,
• If you have high blood pressure,
• If you have congestive heart failure,
• If you experience excessive daytime sleepiness,
• If you are overweight or obese,
• If you fall asleep at inappropriate times (e.g., while driving, talking, etc.),
• If you have morning headaches,
• If you experience constant irritability,
• If you have problems with impaired judgment, inattention, or memory loss,
• If you feel depressed,
• If you have nightmares or disturbing dreams,
• If you walk or talk in your sleep,
• If you have repetitive leg movements while sleeping,
• If you feel temporary weakness in your body or speech muscles during moments of excitement, anger, or intense emotions.

All of these symptoms may indicate a serious sleep-related problem and must be evaluated at a sleep laboratory.

Common Sleep Disorders

Obstructive Sleep Apnea (OSA)

A complete cessation of breathing during sleep is called “apnea,” while a partial cessation is called “hypopnea.” Obstructive sleep apnea occurs due to blockages in the upper airway and can lead to serious consequences.

OSAS is a sleep disorder characterized by the repeated partial or complete blockage of the upper airway during sleep. This blockage is typically caused by the relaxation of the throat muscles, the tongue, and the surrounding soft tissues, which restricts airflow.

During apnea episodes, when breathing stops, blood oxygen levels drop, and a signal from the brain causes the person to wake up and resume breathing. These awakenings are usually brief, and the person is often unaware of them. However, this condition severely disrupts the sleep cycle.

Symptoms:

• Loud snoring throughout the night
• Frequent pauses and resumptions of breathing
• Waking up with a headache
• Fatigue, weakness, and drowsiness during the day

Causes:

• Causes related to the brain
• Excess weight
• Enlarged tonsils or adenoids
• Smoking and alcohol consumption
• Anatomical abnormalities (neck circumference and similar factors)

Treatment:

• Lifestyle changes: Weight loss, quitting smoking and alcohol consumption.
• Use of a CPAP machine: Regulates breathing by keeping the airway open.
• Surgical procedures: Tonsillectomy, procedures to relieve nasal obstruction.

Restless Leg Syndrome (RLS)

It typically manifests as a sensation of discomfort in the legs in the evening or while at rest. This restlessness triggers the urge to move and makes it difficult for the person to fall asleep.

Although the exact cause of Restless Leg Syndrome is unknown, it is believed to be related to a dysfunction in dopamine function:

Dopamine is a neurotransmitter responsible for controlling voluntary movements.

A deficiency of dopamine in the brain or a disruption in dopamine signaling can lead to imbalances in the neural pathways that regulate movement.

Symptoms:

• A tingling, crawling, itching, or burning sensation in the legs
• A feeling of restlessness that is often relieved by movement
• Involuntary leg movements during sleep

Causes:

• Iron-deficiency anemia
• Kidney failure
• Chronic conditions such as diabetes or neuropathy
• Genetic predisposition

Treatment:

• If there is iron deficiency, iron supplementation
• Muscle relaxants or dopamine-regulating medications
• Regular exercise and leg massage

Insomnia

A common sleep disorder characterized by difficulty falling asleep, staying asleep, or waking up very early in the morning and being unable to fall back asleep. Insomnia can affect a person’s sleep quality and quantity, leading to daytime fatigue, concentration problems, and a decline in overall quality of life.

Causes:

• Stress, anxiety, or depression.
• Physical health issues such as chronic pain, asthma, or acid reflux.
• Use of caffeine, alcohol, or stimulant medications.

Treatment:

• Practicing good sleep hygiene (for example, avoiding screens before bed).
• Cognitive behavioral therapy (CBT).
• Medication (sleep aids or melatonin).

Hypersomnia (Excessive Sleepiness)

A sleep disorder in which a person experiences excessive daytime sleepiness and feels the need to sleep throughout the day despite getting enough sleep at night. Hypersomnia can negatively affect daily life and functioning and is often associated with an underlying medical condition. This condition can impair a person’s concentration, energy levels, and quality of life.

Causes:

• Narcolepsy

• Sleep apnea

• Thyroid disorders or medication side effects

Treatment:

• Treatment of the underlying condition
• Improving sleep patterns and maintaining good sleep hygiene

Narcolepsy

It arises from a disruption in the brain’s sleep-wake regulator. It is a chronic neurological disorder that affects the central nervous system and causes the person to fall asleep suddenly and uncontrollably. People with narcolepsy experience excessive daytime sleepiness and have a dysfunction in the mechanism that regulates the sleep-wake cycle. Sleep attacks can occur at any time during the day, usually unexpectedly, and can seriously affect a person’s daily life.

Symptoms:

• Uncontrollable sleep attacks during the day
• Muscle weakness or sudden falls (cataplexy)
• Sleep paralysis (inability to move upon waking)

Treatment:

• Stimulant medications
• Taking short naps during the day

Parasomnias

These conditions are characterized by the occurrence of abnormal behaviors during sleep. They typically occur during transitions between sleep and wakefulness, in different stages of sleep, or upon waking. Parasomnias can affect sleep quality and may cause discomfort or safety concerns for the individual or those around them.

Sleepwalking:

• The person gets up, walks, or performs daily activities while asleep.
• It is most commonly seen in childhood and decreases with age.

Night Terrors:

• Sudden screaming and waking up in fear.
• Most commonly seen in children.

Nightmares:

• Waking up from bad dreams.
• More common after stress or trauma.

Circadian Rhythm Disorders

A sleep disorder resulting from the body’s natural biological clock (circadian rhythm) becoming out of sync with the sleep-wake cycle. The circadian rhythm is an internal clock that regulates the body’s biological processes based on a 24-hour cycle and controls many physiological processes such as sleep, wakefulness, hormone secretion, and body temperature. This disorder can result in a person being unable to fall asleep or wake up at the times they should.

Examples:

Jet Lag: Difficulty adapting after a rapid time zone change.

Shift Work Syndrome: Manifests as excessive sleepiness, fatigue, and insomnia in individuals working night shifts.

REM Sleep Behavior Disorder

A type of parasomnia in which dreams are expressed through physical movements or sounds during sleep. Normally, during REM (rapid eye movement) sleep, the body’s muscles are temporarily paralyzed, and the person experiences their dreams without moving. However, in REM Sleep Behavior Disorder, this paralysis mechanism does not function properly, and the person expresses the content of their dreams through movement. This condition can be dangerous for both the person themselves and their bed partner.

Symptoms:

• Shouting, kicking, or moving during dreams.

May be associated with neurological disorders. Treatment typically involves addressing the underlying neurological condition, and sleep medications may be used to prevent violent nighttime episodes.

Bruxism (Teeth Grinding)

This condition is characterized by clenching, grinding, or tightly clamping the jaw during sleep (sleep bruxism) or while awake (wakeful bruxism). This condition can damage the teeth, the temporomandibular joint, and surrounding tissues. Bruxism usually occurs unconsciously and can negatively affect oral health and overall quality of life over time.

Consequences:

• Jaw pain and damage to tooth enamel.
• Treatment options include dental appliances, botulinum toxin, or various medications.

Night Eating Syndrome (NES)

This is an eating disorder characterized by a person eating excessive amounts of food throughout the night or feeling the need to wake up at night to eat. NES can negatively affect both a person’s eating patterns and sleep rhythm. It is generally associated with psychological factors such as stress, anxiety, and depression and can lead to a decline in an individual’s quality of life.

Symptoms:

• Consuming a large portion of daily calories in the evening or at night.
• Nighttime Eating Binge Episodes.
• Weight gain
• Frequently waking up to eat at night.
• Sleep disruption and waking up feeling tired

Lack of Control

• Inability to control nighttime eating habits
• Frequent feelings of “being unable to stop oneself”

Psychological Factors:

• Conditions such as stress, depression, and anxiety can trigger nighttime eating behavior.
• Eating may be used as a form of “self-soothing” to cope with negative emotions.

Biological Factors:

• Imbalances in melatonin (sleep hormone) and leptin (satiety hormone) levels.
• Increased levels of cortisol (the stress hormone).

Sleep disorders not only reduce an individual’s quality of life but also pave the way for many serious health problems, such as heart disease, diabetes, and depression. Recognizing the symptoms and consulting a sleep specialist or neurologist in a timely manner is critical for initiating appropriate treatment.