If you’re
sleepless in Savannah, Debbie Barreto can help figure out
why.
"We make our living by watching
people sleep," says Debbie, a polysomnographic
technologist in Savannah, Georgia. Polysomnographic
technologists monitor the activity of adults and children
in sleep laboratories. They observe patients, collect
data, and take notes during a sleep study. Then, they
summarize the information for a sleep physician, who makes a diagnosis and
recommends treatment.
The results of a polysomnographic
technologist’s effort are likely to be welcome news.
Usually, people seek evaluation in a sleep lab because
they have trouble going to sleep, staying asleep after
they go to bed, or staying alert when they are awake.
Sleep studies identify which, if any, of
about 100 sleep disorders a person has. "It’s one
thing to know
you have sleep apnea," says Debbie, referring to a
common disorder. "It’s another thing to see hard
numbers that reveal an overworked heart, stressed
repeatedly by low oxygen levels caused by repetitive
collapse of your airway during sleep." Those details
can lead to the right treatment and, ultimately, to better
sleep.
Before patients make an appointment for a
sleep study, they complete a questionnaire about their
sleep habits. This information helps the polysomnographic
technologist and sleep physician determine what kind of
study to conduct.
When a patient arrives at the sleep lab, a
technologist such as Debbie gathers routine medical
information and explains the testing process. The patient
is then taken to the room designated for his or her sleep
study. At a minimum, this room contains a bed; video
surveillance equipment, which allows the technologist to
observe the sleeping patient; and electronic monitoring
equipment, which collects data on the patient’s brain
waves, heart rate, muscle activity, and other body
functions during sleep.
The patient prepares for bed while Debbie
calibrates the equipment. Then, using a special adhesive,
Debbie applies sensors to the patient’s scalp, face,
chest, abdomen, and legs. These sensors, which connect to
the monitoring equipment in the room, have ample wiring to
permit normal movement during sleep.
Debbie’s monitoring tasks begin as soon
as the patient gets into bed. Throughout the study, she
tracks as many as 24 channels of electronic data from a
separate observation room; at the same time, she observes
the patient for movements, such as changing positions, and
other sleep occurrences.
Debbie also takes meticulous notes to
document
corresponding routine occurrences, such as stages of
sleep. "The primary goal in a sleep study is to
collect
accurate data," says Debbie. "But the
technologist’s input of what happens during sleep is
very important."
Polysomnographic technologists are a
patient’s primary contact throughout a study. Except on
rare occasions when a patient may need emergency
intervention, however, the technologist remains in the
observation room. Ideally, a patient’s sleep during the
study should mimic his or her typical slumber as closely
as possible.
When a patient awakens at the end of the
study, Debbie removes the patient’s sensors. She answers
any questions that the patient may have—apart from
conclusions of the study, which have not yet been
determined.
After the patient leaves, the analysis
begins. The analysis involves reviewing all records from
the study and scoring the results. Scoring is a method of
tallying points that are assigned to different sleep
occurrences, such as snoring, to look for patterns,
similarities, or anomalies. It’s no small undertaking: A
single study of one patient can yield more than 1,000
pages of records, with each page representing 30 seconds
of sleep.
After a study is scored, the technologist
sends the
report to a sleep physician for interpretation, diagnosis,
and suggested treatment. Technologists often assist patients in understanding and adjusting to the recommended
treatment.
The U.S. Bureau of Labor Statistics does
not collect employment or earnings data on
polysomnographic technologists. However, the Board of
Registered Polysomnographic Technologists (BRPT) estimates
that there are more than 7,000 registered technologists
internationally. And the Association of Polysomnographic
Technologists (APT), in a 2003 survey, found that
polysomnographic technologists had biweekly earnings
averaging $1,719, with registered technologists earning
slightly more than their noncredentialed counterparts.
BRPT registration, which requires
technologists to pass an exam and meet other conditions,
is often preferred by sleep-lab employers. But applicants
for this credential must first become polysomnographic
technologists. They do this by completing an
associate-degree program with an emphasis in
polysomnography, completing a polysomnography program
accredited by the APT, or gaining equivalent proficiency
in another healthcare-related occupation and then
cross-training in polysomnography.
Polysomnographic technologist training
requires classes in computer science; physical and life
sciences, such as chemistry, anatomy, and physiology; and
mathematics, including algebra, trigonometry, and
statistics.
Debbie, who has taught courses for BRPT
test preparation, says math is one area in which many
students are lacking. "Most of the people who are
sitting for the exam a second time are taking it again
because they failed basic math," she says. "You’ve
got to be able to know when the computer’s wrong."
Debbie also recommends that
polysomnographic technologists have training in a variety
of other subjects. In fact, she says, "I can’t
think of a single class I took that I don’t use."
Courses such as speech and interpersonal communication are
good preparation for interacting with the public.
Polysomnographic technologists must enjoy
working with people. They should also be prepared to work
at night. Sometimes, such as when a shorter sleep study is
required or when a patient’s night job requires daytime
sleep, studies are done during the day. But because most
people sleep at night, most sleep studies take place at
night.
The duties of night technologists differ
from those of others, like Debbie, who work during the
day. "As with most healthcare professions," she
says, "part of what we do is dictated by when we
work." Debbie spends more time on sleep-study
analysis and scoring, for example, than on observing
patients, collecting data, and taking notes.
What technologists do is also affected by
how skilled they are. Debbie’s 20-plus years of
polysomnography experience qualify her to serve as a team
leader, a role that involves additional administrative
tasks in overseeing the 4-bed sleep lab in which she
works. Some technologists apply their knowledge to related
opportunities in marketing, advocacy, and product sales.
And some, like Debbie, are also involved in research,
patient and professional education, and community outreach
projects.
But at the end of the day, it’s the
study of sleep that most interests Debbie. "Every
time you do a sleep study, you see something
different," she says. "Looking at the data,
finding those gems of differentiation to share with the
doctor—that’s rewarding."
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