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  • Tuesday | 27-June-2017

Sleep Laboratory

Sleep Laboratory

 

In-Charge

  Dr Rajnish Gupta

Chest Specialist

Dr. Saroj Meena

Staff

Mr Shaiby

            A Sleep Lab has been fully operational within the Institute since May 2004. It is headed by Dr Rajnish Gupta, Senior Chest Specialist, who is being assisted by Dr Saroj Meena, Chest Specialist  and Mr Shaiby. Various activities of the Department are the enrollment of patients suspected with a sleep related breathing disorder, the conduct of Sleep Study (Polysomnography) and Positive Airway Pressure Titration, their manual scorings and reportings with appropriate recommendations. In addition, teaching and training, research and publications on the subject are also being carried out regularly. 

Infra-structure

The Sleep Lab has 2 rooms – one with a comfortable bed for the patient to sleep on and the other for the technician who records the study. The equipment used for recording the sleep study is Compumedics E-Series Polysomnograph which has an interface box, a control module and a power supply unit. It can monitor upto 57 channels. The Sleep Lab equipment can conduct the study of one patient at a time, though it is upgradable for the recording of four patients at a time. The Polysomnograph in the patient’s room is connected through LAN with the Computer (Monitor, CPU and Printer) in the technician’s room, where the study gets recorded. The Department is using the PSG III software, which is American Academy of Sleep Medicine (AASM) compliant. A  BIPAP Machine is available in the Sleep Lab for carrying out CPAP or BIPAP Titrations of the diagnosed patients with OSA.

 The Sleep Lab is a quiet and a comfortable place for sleeping with the facility of air-conditioning, communication with the technician in case of need, providing Oxygen inhalation either during the baseline study or during the titration study and UPS for an un-interrupted electrical supply. Regular procurement of supplies and maintenance of the equipment facilitates the provision of a quality care to the patients with sleep disordered breathing. 

 

Services   

Sleep Lab is diagnosing patients with sleep related breathing disorders. All suspected cases of sleep disordered breathing like obstructive sleep apnoea (OSA) etc., referred from the out-patient department of the Institute or from the other hospitals, are enrolled in the Sleep Clinic run every week on Tuesdays. Detailed findings of their history and the general examination are recorded in a specially designed proforma. Relevant investigations are carried out and necessary instructions given to them. In order that they get acquainted with the Sleep Lab, they are made to visit the lab at least once before the conduct of the study. On the scheduled date, an overnight polysomnography is conducted in the sleep lab on the Compumedics E-Series PSG III software. The recorded study is analyzed both automatically and manually, interpreted and reported with specific recommendations.

 

All diagnosed cases of sleep disordered breathing are appropriately subjected to a Continuous Positive Airway Pressure (CPAP) or Bilevel Positive Airway Pressure (BIPAP) titration in the Sleep Lab during the simultaneous conduct of a polysomnography. The titration study is also analyzed both automatically and manually, interpreted and reported with specific recommendations to the patients for using the requisite pressure during sleep. Subsequently, the follow-up sleep studies are conducted and patients are given appropriate instructions. More than 150 sleep studies including the PAP titrations are being carried out annually in the Sleep Lab.

Teaching and Training

The diagnostic and therapeutic evaluation of sleep related breathing disorders is being taught  to  the  doctorand  the  staff  including the  postgraduate  DNB  students and  the senior residents of the Institute. The subject is also covered in the teaching curriculum of the residents as per the academic schedule through lectures, journal clubs, seminars etc. Teaching and training on the subject is also carried out regularly for the benefit of the trainee doctors and staff from the other Institutes as well. A Workshop on Sleep Study was carried out on 23rd February 2014 as a pre-conference Workshop in NATCON 2013 at the Institute from 23rd to 26th February 2014 for the delegates enrolled in the Workshop. Many lectures were delivered on the subject and a live demonstration of the sleep study was given to the delegates. A Sleep Lab Training was carried out for four doctors (two from GSVM, Kanpur, one from RBTB Hospital, New Delhi and a private practitioner) and two staff of NITRD between 16th to 31st January 2015.

 

Research   

Many research projects on the subject are being / have been carried out regularly in Sleep Lab over the years. Some of these are:

  

1.   To study the effect of intervention (intensive patient communication) on short term adherence of Positive Airway Pressure therapy in diagnosed cases of obstructive sleep apnoea and to determine the reasons of non- compliance.

2.    Sleep Oxygen De-saturation in late Sequelae of Pulmonary Tuberculosis.

3.       To determine the existence and pattern of sleep disordered breathing in cases of interstitial lung diseases.

4.       To correlate Mallampati scale and cephalometric parameters with the presence and severity of sleep related breathing disorders in Indians.

5.       Correlation between Quality of Sleep, Depression, Bode Index and Quality of Life in COPD patients.

6.      To determine and to compare the initial and final effective pressure levels in the adult patients with obstructive sleep apnoea.

7.      To determine the existence and pattern of sleep disordered breathing in non-obese adult Indian snorers.

8.      To determine the pattern of Sleep Disordered Breathing in Obese Indian Subjects.

 

Publications

Articles and Chapters on sleep have been published in well-known journals or books. Some of these are:

i) Y. K. Gupta, A. Jaiswal, R. Gupta, A. K. Jain, D. Kumar, D. Behera. Pattern of sleep disordered breathing in obese Indians. Indian J Sleep Med 2009; 4 (1): 19-31.

ii) Rajnish Gupta, D.Behera. Essentials of Polysomnography and recommendations in adults. In: Behera D, Gaur SN, Katiyar SK, Gopal B, Gupta KB, Luhadiya SK, editors. NCCP Textbook of Respiratory Medicine. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd. 2011; pp 756-765.

iii) V.K.Arora, Rajnish Gupta. Interpretation of polysomnography and management of obstructive sleep apnoea-hypopnea syndrome. In: Arora VK, Arora R, editors. Practical approach to critical respiratory medicine, sleep disorders and fiberoptic bronchoscopy. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd. 2006; pp 602-613.

 

Future Vision

Efforts are on to strengthen the Department with a better staff availability, more supporting equipments and the development of sleep protocols so that the Department could become a premier site for the conduct of training and research in the field of Sleep Medicine in the country.