Testing

Sleep Testing

Sleep Testing (Polysomnography) involves monitoring of brain waves, eye movements and chin muscles, to determine presence and type of sleep. We also monitor brain waves to look for possible seizures, as well as the heart to insure there is no irregular heartbeat, and breathing to detect any signs of altered breathing during sleep. Examining Leg muscle activity allows us to identify abnormal movements in sleep. Monitoring of blood oxygen with a light-emitting probe on the finger shows the effect of altered breathing on blood oxygen levels. In young children we also monitor carbon-dioxide levels in the air they breathe out.

All of this testing occurs in a private room designed to look and feel like a luxury hotel room, inside of our state of the art facility. Throughout the entire night, a technologist is present to monitor you using video and audio monitors and the latest neurophysiological equipment.

The procedure for testing for daytime sleepiness involves monitoring sleep during a series of four to five naps each spaced two hours apart throughout the day. Patients with narcolepsy fall asleep quickly and go into REM sleep in more than one nap, allowing us to make a diagnosis.

Society has long recognized the existence of sleep disorders; however, accurate diagnosis and effective treatment have become possible only in recent decades, afther the discovery of neurophysiological techniques to study sleep and sleepiness.

Now, Sleep Medicine is a well established field, with Board Certification by the Boards of Psychiatry, Neurology, Internal Medicine, Pediatrics and Otolaryngology. The majority of insurance companies cover most of the testing fees. However, the medical reimbursement area changes rapidly, and each third party payer may have its own rules and policies.

Quality of medical care is sleep medicine is assured only by accreditation by the American Academy of Sleep Medicine. The Sleep Disorders Institute was the first accredited sleep centers in the Macomb-Oakland county area, so you can rest assured that you will receive the highest quality of medical attention.

Brain Mapping

Brain mapping of electrical activity makes it possible to study brain function over thousandths of a second, and allows the Attention Disorders Institute to better tailor treatment to each patient. As one of the few centers offering this technology, we believe we are uniquely positioned to help you get your Attention Deficit Brain Disorder/ADD/ADHD treated in the most effective way, without having to experiment with a wide variety of drugs.

In the 1930s, Berger, a German psychiatrist, first discovered electrical brain waves. Any stimulus produces electrical responses in the brain called evoked potentials. Recording these electrical responses, and averaging to remove noise, displays brain activity in response to the stimulus every millisecond (thousandths of a second).

When the stimulus is a cognitive or intellectual task, the recording is a cognitive evoked potential. This examines the intellectual workings of the brain. A selective attention task involves presentation of two stimuli, one less frequently than the other. Auditory stimuli are tones of high and low pitches. Visual stimuli are different letters. When asked to differentiate between the two stimuli, the less frequent stimulus produces the P300, a positive electrical wave in the brain about 3/10 of a second after the stimulus. A small wave indicates problems with attention. A delayed wave indicates problems with information processing.

Brain function may be abnormal only in certain parts of the brain most involved in a specific intellectual task. Recent technological advances make it possible to record and analyze brain electrical activity from a large number of scalp electrodes. With at least 32 monitoring channels, it is possible to draw brain maps of the electrical activity. Earlier, brain mapping using X-rays made it possible to see brain structure (CT scan). Brain mapping using radioactive chemicals made it possible to study brain function over minutes (PET scan). Brain mapping of electrical activity makes it possible to study brain function over thousandths of a second. Testing is in a private room with advanced computer equipment. Application of a cap with 31 electrodes and of electrodes on both ears and near both eyes is painless.