Download Overnight Sleep Study Instructions

Overnight Sleep Study Instructions
Patient: ____________________________________________________________
Appointment Date: ________________ Appointment Time: ______________
*** Please arrive at your scheduled appointment time.
*** Per cancellation policy, a cancellation fee of $200.00 will be applied to your
appointment if you have not informed us of the need to cancel or reschedule
within a minimum of 48 hours prior to your scheduled appointment date &
time.
Locations:
Fleming Island Laboratory
1681 Eagle Harbor Parkway East, Suite B
Fleming Island, FL 32003
Nighttime phone: (904) 493-5363
Daytime Phone: (904) 493-3333
* Ring bell at main entrance of building
AC Skinner Laboratory
7011 AC Skinner Parkway, Ste 160
Jacksonville, Fl 32256
Nighttime phone: (904) 854-2540
Daytime phone: (904) 493-3333
*Ring bell at side entrance of building
(Cath lab & Sleep lab entrance)
Dear Sleep Disorders Center Patient:
Your doctor has scheduled you for a sleep study at one of our sleep disorders laboratories. We
have two state of the art facilities for your convenience.
The Sleep Study:
A sleep study involves sleeping overnight at the laboratory. You will have several small sensors
and different types of monitors taped and glued to parts of the body including your scalp, which
provides information about your sleep and allow us to diagnose potential sleep disorders. A
highly skilled technologist will monitor your sleep throughout the night. Depending on the
results, you may need to return for a follow up test to treat your issues. Your results are
typically available in 1 week and will be reviewed with you during a follow up appointment with
either your referring physician or our board certified sleep physician.
Arrival & what to expect:
 We are an outpatient testing facility and DO NOT provide nursing services. If this is
required, please contact us immediately.
 Family members and/or friends are NOT permitted to stay with you unless deemed
medically necessary or special circumstances that have been pre-approved.


Arrive to the center at your scheduled time as this is an important and time
consuming study. The technologist will explain the details and prepare you for your
sleep study.
There will be some paper work to fill out before the technologist begins applying
sensors to your body. This will take anywhere between 30-40 minutes. Monitoring
will begin shortly after sensors have been applied (as early as 9:00pm, but no later
than 11:00pm). Your study will conclude approximately 5:00am and you will be
discharged no later than 6:00am. We can wake you early upon request.
Transportation:
If someone drops you off or you are taking alternative city transportation, be sure to have your
ride available no later than 6:00am the following morning.
What Should I Bring?
 Prescription and non-prescription medication.
 Pajamas, or loose fitted clothes. You can wear gym or regular shorts. Sleep clothing
must be worn. We do not provide these for you. Women-Do not wear silk tops or robes.
 You may bring your own pillow from home.
 Toiletries (tooth brush, mouth wash, etc.)
 Day of your study Do’s and Do not’s:
 Make sure you eat your dinner before arriving.
 Do not take naps the day of the study.
 Do not drink any caffeine after 12:00 noon. This includes: coffee, tea, chocolate or soda.
You may drink decaffeinated products but please limit your fluid intake.
 Do not drink alcohol at least 12 hours before your study.
 Wash and dry your hair and face before the study.
 Do not use hair gel, mousse, or body lotions on any part of your body prior to your
study.
 Men… if you typically shave, please do so before arriving to remove facial stubble. You
may be asked to shave if this is not done.
 Hair piece, weaves, wigs, Acrylic Nails should be removed.
Special needs:
If you currently have any of the times listed below or have any other specific needs, PLEASE call
the sleep center as soon as possible.
 Wheelchair
 Special bed/ Cannot get in or out of the bed on your own
 Incontinence issues.
 Personal Care Assistance/ Nursing Care.
 Instability, walking on own.
If you have any of questions prior to your study you may reach a sleep technologist by calling
(904) 854-2540 in the evening. Please leave a message if there is no answer and we will call you
back. You can also reach the main scheduling office by calling (904) 493-3333 or South sleep lab
at (904)854-2540 during normal business hours(8:30am-5:00pm) Monday through Friday.
Thank you for choosing First Coast Cardiovascular Institute Sleep Disorders Center!
First Coast Cardiovascular Institute
Sleep Disorders Center
EPWORTH SLEEPINESS SCALE
How likely are you to doze off or fall asleep in the situations listed below, in contrast to
feeling tired?
Use the following scale to choose the most appropriate number for each situation.
0= would never dose
2=moderate chance of dozing
1= slight chance of dozing
3=high chance of dozing
Situations
Rating
Sitting & reading
Watching T.V.
Sitting inactive in a public place
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon
Sitting & talking to someone
Sitting quietly for a few minutes without alcohol
In a car while stopped for a few minutes in traffic
Total
______________________________________________________________________________
MALLAMPATI CLASSIFICATION
Technician:
please determine the Mallampati score by having the patient open their mouth and view the inside of the
patient’s mouth/oropharynx. The patient does not have to strain/stretch the mouth open, just relax and open mouth. Circle the class
which most closely resembles what you see.
First Coast Cardiovascular Institute
Sleep Disorders Center
PRE-TEST SCREENING
Name: ___________________________
MR#: _______________
Date: _______________
Height: ____ft ____ in
Weight: ______lbs
Neck size: ___________
(Please circle/fill in the blank for the correct answer)
1. Did you take any naps today?
Yes
No
2. Have you taken any medications today?
Yes
No
If so, which medications? (Please list them below)
________________________________
_________________________________
________________________________
_________________________________
3. Are you currently on oxygen?
Yes
No
4. What time do you normally go to bed? _______ p.m.
5. What time do you get up? _______a.m.
6. How long does it normally take you to go to sleep? __________
7. Do you sleep with the T.V. on?
Yes
No
8. Do you take medications to make you sleep?
Yes
No
9. Do you have difficulty falling asleep?
Yes
No
10. Have you had any alcoholic beverages today?
Yes
No
11. Have you felt sick today or do you feel sick now?
Yes
No
If yes, please explain: _____________________________________
12. Has anything out of the ordinary happened today? Yes
No
If yes, please explain: ________________________________
13. Did you have difficulty staying awake today?
Yes
No
14. What time did you eat last? __________ A.M. or P.M
15. What time did you last have caffeine? ____________ A.M. or P.M.
16. Could you fall asleep now if you got into bed?
Yes
No
17. Do you feel tired or fatigued right now?
Yes
No
18. How alert do you feel right now?
A little bit
19. Have you ever had a sleep study before?
quite a bit
Yes
No
extremely
If so, where? _______________
20. What physicians are to receive a copy of this sleep study? _Dr._______________________________