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Driver fatigue causes an
estimated 100,000 police-reported crashes every
year, resulting in more than 1500 deaths, thousands of
injuries, and monetary loses in the billions. Chronic sleep
problems are known to contribute to depression, hypertension,
coronary artery disease and stroke. And they can affect our
personal relationships. More than 50 million Americans suffer
from some type of sleep disorder. With training in the
Polysomnography program at Montgomery College YOU can help
them. It wasn't until about 1953 that REM was even recognized,
that REM sleep occurred. That's when it was first described and
understood. So you know we're talking about just about 60
years in which jus th- we've gone from just the basics of
understanding a little bit about sleep to recognizing about 80
different sleep disorders at this point. As you are about to
learn, sleep medicine has evolved into a medical specialty
all its own. Sleep disorders vary, but for most, diagnosis
starts at a sleep study center. The most common things we see,
for example, in the sleep center at Georgetown uh and in most
diagnostic sleep centers for example are obstructive sleep
apnea, which is a disorder when patients when they go into
deeper stages of sleep they lose muscular control in their upper
airway which causes an obstruction in the airway; and
they actually stop breathing during their sleep. With apnea
their oxygen saturations begin to drop the heart rate increases
and cause them to wake up frequently throughout the night
which leads them to be very sleep y on the next day.
Patients who have restless leg syndrome have discomfort in
their legs particularly when they are lying down in the
evening, and most commonly they will have to get up and take a
walk. Walk will relieve their discomfort and then they'll try
and get back to sleep so their sleep does get interrupted.
Another well known sleep disorder is something called
Narcolepsy. Patients with narcolepsy have severe
sleepiness. they'll suddenly have sleep attacks, that's sort
of a characteristic thing, so I must tell you that anybody who
is severely sleep deprived can have these sudden sleep attacks.
Narcolepsy might also include sudden muscle weakness and
hallucinations or vivid dreams. Other common sleep disorders
include: insomnia, in which patients complain of trouble
falling asleep or trouble staying asleep during the night.
And a sub-set of disorders called para-somnias. These can
include sleep walking episodes, acting out one's dreams, and
other unusual behavior while sleeping. The symptoms of most
sleep disorders are what you might expect to see in a person
who isn't getting ENOUGH sleep, despite the fact that they claim
to sleep as many as 8-10 hours a night. Symptoms like Fatigue,
Sleepiness, and trouble concentrating are to blame for
thousands of traffic and industrial accidents every year.
The amount and the cost to society of this in the amount of
hundreds of billions of dollars it's just amazing its estimate
maybe hundreds of thousands of motor vehicle accidents per year
in this country are related to being sleepy at the wheel. The
national transportation safety board which is located here in
DC you know investigates traffic accidents whether on the road or
in the air. Um there have been some airline uh pilots for
example who uh have fallen asleep while flying passengers.
Uh there was a flight uh going uh to one of the islands in
Hawaii an actually overshot the island um because both the pilot
and the co pilot had fallen asleep. So these issues are
getting a lot of attention There's no question that your
efficiency is less if you are significantly sleep deprived and
there are some studies of recurrently sleep depriving
somebody over a period of a few weeks lets say so that they only
have 6 hours of sleep, can't do any catch up sleep and testing
them and some of the tests is very similar to being
intoxicated or having a significant amount of alcohol in
your system. So the the difference is that you're not
necessarily aware that your not functioning on all cylinders
Unfortunately, the not so obvious effects of sleep
disorders are just as dangerous. Many patients suffer from high
blood pressure, heart problems, stroke and depression. Proper
diagnosis and treatment are essential to improving the lives
of those who suffer from sleep disorders and the safety of
those around them. In Polysomnography, sleep studies
are performed to assess and diagnose these disorders. The
trained professionals who perform the studies are known as
Polysomnographic technologists. These technologists assist in
the clinical assessment, physiological testing,
diagnosis, management, and prevention of sleep related
disorders. As a team, physicians, sleep specialists
and technologists work with patients to identify symptoms
and then if necessary, schedule a polysomnogram. This study is
usually conducted overnight in a sleep center. During a sleep
study the technologist uses multiple medical diagnostic
tests to track sleep cycles. We monitor a patient's um
electrical brain activity, brain waves, during the night
and um we have different channels that are scrolling
throughout the night with their brain waves. We monitor their
respiratory activity or their breathing throughout the night,
muscle activity, heart rate, a lot of these different variables
that uh give us a good picture of what's happening during sleep
at night. This requires that a series of sensors that are
placed on the patient's head, face and chest. Sensors glued to
the scalp monitor the brains activity. There are sensors that
are glued or pasted near the eyes that monitor the movement
of the eyes and that information is also important in finding
what stages of sleep the person is in. Electrodes placed at the
collarbone and on the chest measure heart rate and rhythm.
Sensors placed on the legs and chin monitor muscle movement
during sleep. There'll be a sensor that is in front of the
nose and the mouth or in the nose and there's a little lil
thing that goes into the mouth also. It monitors the air coming
in and out of the mouth and the nose. That's one of the
respiratory measures that we use. Usually we'll have 2 belts,
one on the chest and one on the abdomen that also monitors the
movement of the chest and abdomen that helps us understand
about the breathing There' ll be an oxygen sensor placed on you
fingertip so we can monitor your oxygen level throughout the
night uh also there'll be a little microphone um taped near
your throat which will monitor for the snoring. And video
cameras are sometimes used to monitor patient movement during
the study. The data th that uh we obtain from the sleep study
is really extensive um an average sleep study may be 800
to 1000 pages of information and if we have you know 10 or 15
different channels of uh data from all of the different uh uh
leads and signals that we place during the study we've got 800
pages of each of those so during the day a technologist will
actually go through and analyze um all of the different data
that we've obtained during the sleep study and they will uh
compile statistics from how the patient was breathing um how
steadily they slept during the night, how often did they wake
up? You know did they have neurological arousals regularly
due to breathing disorders, anything like that? Uh and uh
we'll compile a report of statistics that a physician will
then interpret as well so its pretty labor intensive to uh
score and report on a sleep study uh all of that happens
after the patient leaves and then once that report is
completed it will be sent back to the ordering doctor and
they'll move forward with treating the patient. When we
have a technologist who is almost alone with a patient
during the course of the night that technologist has to make
significant decisions with some patients who could be very sick,
whose breathing might stop 60 times 70 times an hour, that's
more than once a minute and they have to decide how to treat that
patient, so we want people who are well trained and we think we
need a uniform training we need an adequate training program, so
that we know that when a pa- when a polysomnography student
has gone through the training, and they're gonna be going in-
into the work field that we're comfortable with having them
taken care of such sick patients so I think we need to have good
training programs I think that the program that we've set up is
an excellent training program it sort of really lays the ground
work. For technologists to come into the job market with
formal education in sleep technology gives them a leg up.
The polysomnography program at Montgomery College began in the
fall of 2009 with our first group of students The program
currently consists of courses that deal with sleep medicine
technology. These include anatomy and physiology,
psychology, computer applications, and others.
Students get hands-on lab practice and participate in
clinical rotations at hospitals and sleep centers in the DC
Metro area. During those uh rotations, they're uh working
alongside experienced sleep technologists and getting some
real hands on experience with patients, um and during that
course of those clinical hours they're actually getting to the
point where they're becoming competent themselves and
actually performing the studies themselves under the supervision
of those technologists.
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Basically what I do uh is
hooking up the patient and they just tell you ok do the hook up
and we are watching you if you do something wrong we help you
and that you know kind of giving uh uh uh encouraging you in
order to do by yourself everything so in order to get
experience and uh so far they have done their best of my
knowledge and uh I have no problem with them I learn a lot
and I did hook up many times by by myself Interaction with the
patients uh that's what I have to do first time because you
have to make them comfortable with everything Patient care is
important you know patient care comes first um like anything
where i- my particular clinical site here is the VA and what we
do is we work with a lot of veterans and so we do ge- w-w-we
get a lot of interesting cases. Lots of interesting cases I like
that our instructors have been in the field for a very long
time some of them have almost 20 years experience the little
things and the questions that we have, they always know how to
troubleshoot for us . Anytime I have questions and I just call
them or uh email them or approach them in person one to
one so far I have no problem at all I think choosing Montgomery
College was a valuable choice. I'm the type of person who
learns better from teachers explaining rather than just
learning it from a computer, so the fact that the teachers give
us the hands on experience they can as- answer questions for us.
We ac- they actually care about what we're doing in the lab. Is
a career in Polysomnographic technology right for you?
Someone who um works in sleep medicine would need to at least
be prepared, if not for their entire career, at least for a
period of their career be prepared to work um at night
doing acquisition studies with patients. You have to be um
self-motivated. Have a way to make the patients comfortable in
an unfamiliar environment with unfamiliar circumstances and
unfamiliar people um you're coming in and sleeping in a
place with uh wires on your head and uh you know someone's
watching you but you know it's not an uncommon thing for the
best technologists that I know to get reports back from saying
you know I wouldn't have even known I was in a hospital and
that sort of thing so you need someone who you know enjoys
being around people and uh is good at developing a rapport
with with people and really wants to help the
patients that they serve. Once students successfully
graduate from the program, they are eligible to sit for the
RPSGT, or Registered Polysomnographic
Technologist exam which is presented by the BRPT or
Board of Registered Polysomnographic Technologists.
This credential is the gold standard in the field of sleep
medicine technology credentials. Each exam is computerized, uh
you get immediate feedback upon completion to let you know
whether or not you passed or failed. Um the credential's good
for 5 years. You have to maintain a minimum of 10
continuing education credits each year to maintain your
credential. This is a field a person should consider, you can
definitely sustain a good livelihood. I've been a sleep
tech for over twenty-something years. Uh, I've been able to
help my kids go through college uh as a result of being a sleep
tech. Uh, there's good money to be made in the field. Um, it's a
good field to work for, especially if you like helping
people. And one of the biggest uh benefits of being a sleep
tech is you get to see immediate results. A new graduate
uh could start work probably almost immediately after
graduation. Clinical students will have uh much exposure to
working in the lab uh so the jobs are out there. The salary
range varies pretty significantly um based on
geography. I would say in the DC area we have a good uh one of
the higher salary ranges nationally. Sleep
technologists in the Maryland Washington DC area can make as
much as $25 or $30 or more per hour upon graduation. It's also
you know a field where we've got good job security there's a lot
of jobs out there. um I'm looking to hire several
technologists myself right now so it's got a lot of job
security and a lot of opportunity for advancement um
for technologists There's over 50 million people that uh have
sleep apnea that's undiagnosed so there's a lot of patients out
there. There's a lot of work that needs to be done. so uh if
a person was looking for some type of career field or looking
for longevity in a career field uh being a sleep technologist is
definitely a good field to consider. Recognizing the
importance of these illnesses, the cost to society of the sleep
problems and recognition that we really need to attend to this,
is all sort of coming together at the same point. So I think
that that sort of makes it clear that we really really need
people to enter the field, we really need more capacity to
diagnose people, to treat people. Sleep technology is very
rewarding for the technologist performing um the uh study for
the patients. We get to see on the short term uh a positive
outcome for our patients we get to see um them wake up often
times the next morning feeling refreshed and they may say this
is the first time they've felt this well, this is the first
good night's sleep I've had in many years. If you are
interested in learning more about the Polysomnography
program at Montgomery College, please visit us on the
web at montgomerycollege.edu/ and
search for polysomnography
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