If you regularly feel tired during the day, you should talk to your doctor. There are a wide range of sleep disorders and for many conditions, only a visit to a sleep study center and a sleep test can tell which is causing the problems.

If you have any of these symptoms it is worth consulting a doctor:

• It often takes a long time to fall asleep (more than 30 minutes).
• You often wake up too early without feeling refreshed
• You often wake in the night and can’t get back to sleep

These are all symptoms of insomnia.

• Your sleeping partner notices that your breathing stops sometimes
• Your partner reports loud snoring, snorting or choking sounds when you sleep.

These are symptoms of sleep apnea.

• You have tingling or crawling feelings in your legs at night that are eased by movement or massage
• Your legs or arms jerk around at night

These are symptoms of restless leg syndrome.

• You sleep very easily in the day
• Anger, fear or laughter results in sudden muscle weakness
• You feel as if you are paralyzed when you first wake up
• Whilst falling asleep or dozing you have very vivid dream episodes

This could mean narcolepsy, a condition when people sleep without meaning to and sometimes without even noticing.

Only a doctor can explore these symptoms fully.

All sleep disorders have serious health consequences and many are easily curable.

As many as fifty percent of doctors will never ask how you are sleeping, so it is important to raise the issue yourself, if you think there might be a problem.

Questionnaires and Sleep Diaries.

The first step in a medical assessment is a questionnaire and sleep diary.

You will be asked to write down when you sleep, how long it takes to fall asleep, what time you wake up and any sleeping during the day. You will also be asked to keep a record of any stimulants that you use like coffee or nicotine and any exercise that you do

Actigraphs

Actigraphs are often used to provide a record of activity. These are small motion sensitive instruments worn on the wrist, ankle or waist. They store information about your movements which can be downloaded to a computer. Software can work out when you sleep and also help identify unusual behaviour whilst you sleep.

Recommendation for a Sleep Study

If your doctor suspects a sleep problem but cannot be sure of the diagnosis he will probably ask you to attend a sleep centre, especially if he suspects sleep apnea or a 'parasomnia' like sleep walking. Insomnia does not need a visit to a sleep center for a diagnosis to be made.

Sleep apnea is a condition that involves periods of not breathing during sleeping which can have serious long term health risks for high blood pressure and heart attacks. Approximately twenty million Americans suffer from this condition.

Diagnosis of many sleep disorders involves staying overnight in a sleep study center. The tests are painless, require no injections or needles and are administered by technicians rather than doctors or nurses. Wires are attached to your head, legs, fingers and chest and a machine called a polysomnogragh measures such things as heart rate, blood oxygen, brain activity and chest and limb movements.

The image above shows a child wired to a polysomnograph. There is no limitation on movement, though if you need to use the bathroom during the night, you will need to ask for someone to unplug the connections.

You are asked to sleep in a room of your own whilst a technician in a nearby room monitors the polysomnograph. If you have an episode of sleep anea you will probably be woken and asked to wear a special mask (see image) which will increase the flow of air to your lungs. You will then be allowed to sleep again.

The information collected is saved for your doctor to examine.

Sleep latency tests are often used to detect narcolepsy- a condition where a person falls asleep involuntarily for short or long periods during normal waking hours. This test can be a requirement for some occupations and is performed in a sleep center.

If you are to be assessed in this way, you will be asked to stay awake whilst resting quietly in a room wired to a polysomngraph.The objective is to see if you sleep or not and how quickly. If you do sleep, a technician will wake you after about ninety seconds.

There will a series of tests like this every two hours or so. The first will usually be about two hours after you wake up. After that you will be required to stay awake for about two hours before the procedure is repeated. A technician in a nearby room will monitor the polysomnograph and save the information as a polysomnogram for your doctor.

Following a sleep study, the information is sent to your doctor who will make a diagnosis and discuss a treatment program with you- if one is needed.

Sleep center studies can be expensive if you are not covered by insurance- ranging from $1,500 to $3,000. Less expensive home testing is possible with a range of simple to use devices supplied and interpreted by specialists. Most ordinary doctors will only use these for screening patients who they think might need to be assessed in a sleep center. Some specialists will make a diagnosis and offer a treatment plan without the need for a sleep center.