The author is a Registered Sleep Technologist with over 40 years experience in Sleep and Cardiopulmonary medical technology. He has managed AASM accredited sleep centers, pulmonary function laboratories and neurodiagnostic centers since the 1970’s and taught college courses in Sleep and Respiratory technology for nearly 30 years. He has been an invited lecturer at national conventions for polysomnographic and neurodiagnostic technologists for decades. This second edition of the Handbook for Sleep Medicine Technologists includes sections on Fundamentals, Theory, Techniques, Therapeutics and Follow-up, and incorporates the latest AASM scoring rules, new ICSD-2 codes for sleep disorders, and latest treatment modalities for sleep apnea. It also includes a new self-test section with multiple questions and answers covering every chapter.
Handbook for Sleep Medicine Technologists
Second Edition
by Steven H. Lenik, RPSGT, RST
Handbook for Sleep Medicine Technologists
Second Edition
by Steven H. Lenik, RPSGT, RST
Published Feb 20, 2009
342 Pages
Genre: HEALTH & FITNESS / Health Care Issues
Book Details
BEST TRAINING GUIDE FOR NEW TECHNOLOGISTS
Handbook for Sleep Medicine Technologists is the consummate tool for polysomnographic technologists, respiratory care practitioners, neurodiagnostic technologists, nurses, physician’s assistants, and any other practitioners who need to understand or perform sleep studies. Students will find it particularly useful, as the book begins with fundamental principles and describes materials, techniques and expected results in great detail. From choosing equipment and setting up a sleep center to hooking up patients, running tests and scoring polysomnograms, the handbook covers every aspect of a technologist’s job. There is also a large section on principles and theory, including effects of pharmacologic agents on sleep and a complete discussion of all currently recognized sleep disorders. This book is a perfect companion for any practicing technologist, student, or layperson wanting to understand the practice of sleep technology. It is an excellent reference and review source for the Registered Polysomnographic Technologist (RPSGT) Examination, and is utilized extensively by the American Association of Sleep Technologists (AAST) as a teaching guide in the Syllabus of the Curriculum in Polysomnographic Technology.
Book Excerpt
With this knowledge in hand, the AASM manual lays out specific rules for determining each stage.
In general, as sleep progresses from stages 1 through 4, the EEG increases in amplitude (gets larger) and decreases in frequency (gets slower).
Wakefulness actually has two distinct patterns. When the subject is awake and alert, the pattern is one of a relatively fast, mixed frequency, low voltage EEG. Although this pattern slows as the subject falls into deeper sleep, a background of mixed frequency, low voltage EEG is almost always visible in all stages. The other EEG pattern of wake is one of relaxation, usually with eyes closed. This consists of almost continual alpha waves, in the frequency of 8 – 13 hertz. Note that the alpha pattern will always be slower than the sleep spindles in the same subject.
The waves in stage N1 will be primarily in the theta range of 2 – 7 hertz. Vertex sharp waves may also be seen, occasionally as high as 200 µV in amplitude. Slow, rolling eye movements and reduced EMG amplitude are commonly seen in this stage, but these are not criteria for scoring.
Sleep spindles, which help determine stage N2, are defined as 12 – 14 hertz waves lasting at least 0.5 seconds. K-complexes are well-delineated negative sharp waves followed immediately by a positive component, and lasting at least 0.5 seconds. They may or may not occur in conjunction with spindles. There are no amplitude criteria for sleep spindles or K-complexes.
The slow waves of stage N3 are in the delta range of 0.5 to 2 hertz, and must be at least 75 µV in amplitude, peak-to-peak in the frontal regions. (Note: As we age, EEG amplitude often decreases. It is for this reason some laboratories ignore the voltage criterion for slow wave sleep and score slow waves by frequency alone.)
In REM sleep, the EEG is similar to stage N1, except no vertex waves will be seen, and saw tooth shaped waves in the theta band are often seen instead. Rapid eye movements must also occur, and the EMG of the chin must be lower in amplitude than in any other stage.