Procedures
Procedures
Bronchoscopy
What Is Bronchoscopy?
Bronchoscopy (bron-KOS-ko-pee) is a procedure that allows your doctor to look inside your lungs’ airways, called the bronchi (BRONG-ki) and bronchioles (BRONG-ke-ols). The airways carry air from the trachea (TRA-ke-ah), or windpipe, to the lungs.
During the procedure, your doctor inserts a thin, flexible tube called a bronchoscope into your nose or mouth. The tube is passed down your throat into your airways. If you have a breathing tube, the bronchoscope can be passed through the tube to your airways. You’ll be given medicine to make you relaxed and sleepy during the procedure.
The bronchoscope has a light and small camera that allow your doctor to see your windpipe and airways and take pictures.
If you have a lot of bleeding in your lungs or a large object stuck in your throat, your doctor may use a bronchoscope with a rigid tube. The rigid tube, which is passed through the mouth, is wider. This allows your doctor to see inside it more easily, treat bleeding, and remove stuck objects.
A rigid bronchoscopy usually is done in a hospital operating room using general anesthesia (AN-es-THE-ze-ah). The term “anesthesia” refers to a loss of feeling and awareness. General anesthesia temporarily puts you to sleep.
Overview
Bronchoscopy can help find the cause of a lung problem. For example, during the procedure, your doctor may see:
•A tumor
•Signs of infection
•Excess mucus in the airways
•The site of bleeding
•A blockage (such as a piece of food) in your airway
Your doctor also may take samples of mucus or tissue from your lungs to test in a laboratory.
Sometimes doctors use bronchoscopy to treat lung problems. For example, the procedure might be done to insert a stent in an airway. An airway stent is a small tube that holds the airway open. It might be used if a tumor or other condition blocks the airway.
In children, bronchoscopy most often is used to remove an object blocking an airway. Sometimes it’s used to find out what’s causing a cough that has lasted for at least a few weeks.
Researchers are studying new types of flexible bronchoscopy. They might make it easier to detect tumors and other lung problems, especially in the lungs’ small airways. These procedures also might make it easier to take fluid and tissue samples from your lungs.
Newer types of bronchoscopy include:
•Endobronchial (EN-do-BRONG-ke-al) ultrasound. This procedure uses sound waves to create pictures of the insides your airways.
•Fluorescence (flor-ES-ents) bronchoscopy. This procedure uses fluorescent light instead of white light to look inside your airways.
•Virtual bronchoscopy. This procedure uses a new method of computed tomography (to-MOG-rah-fee) scan, or CT scan. Virtual bronchoscopy can create detailed pictures of your airways.
Outlook
Bronchoscopy is a safe procedure. Side effects and complications usually are minor. You may feel hoarse and have a sore throat after the procedure. Minor bleeding, infection, and fever also can occur.
A rare, but more serious risk is a pneumothorax (noo-mo-THOR-aks), or collapsed lung. In this condition, air collects in the space around the lungs, which causes one or both lungs to collapse.
Source: National Heart Lung and Blood Institute
Who Needs Bronchoscopy?
Your doctor may recommend bronchoscopy if you have an abnormal chest x ray or chest CT scan. These tests may show a tumor, a pneumothorax (collapsed lung), or signs of an infection.
A chest x ray creates a picture of the structures in your chest, such as your heart and lungs. A chest CT scan uses special x rays to create detailed pictures of the structures in your chest.
Other reasons for needing bronchoscopy include coughing up blood or having a cough that lasts more than a few weeks.
Sometimes doctors use bronchoscopy to treat lung problems. For example, the procedure might be used to:
•Remove something that’s stuck in an airway (like a piece of food).
•Place medicine in a lung to treat a lung problem.
•Insert a stent (small tube) in an airway to hold it open. A stent might be used if a tumor or other condition blocks an airway.
Doctors also can use bronchoscopy to check for swelling in the upper airways and vocal cords of people who were burned around the throat area or who inhaled smoke from a fire.
In children, the procedure most often is used to remove an object blocking an airway.
Source: National Heart Lung and Blood Institute
What To Expect Before BronchoscopyBronchoscopy is done in a hospital or special clinic. To prepare for the procedure, tell your doctor:
•What medicines you’re taking, including prescription and over-the-counter medicines. It’s helpful to give your doctor a list of your medicines.
•Whether you’ve had any bleeding problems.
•Whether you have any allergies to medicines or latex.
You’ll be given medicine before the procedure to help you relax. The medicine will make you sleepy, so you should arrange for a ride home after the procedure.
You’ll have to fast (not eat or drink anything) for 6–12 hours before the procedure. Your doctor will let you know the exact amount of time you should fast.
Source:National Heart Lung and Blood Institute
What To Expect During Bronchoscopy
Your doctor will do the bronchoscopy in an exam room at a hospital or special clinic. The procedure usually lasts about 30 minutes. But the entire process, including preparation and recovery time, takes about 4 hours.
Your doctor will give you medicine through an intravenous (IV) line in your bloodstream or by mouth. The medicine will make you relaxed and sleepy.
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Your doctor also will squirt or spray a liquid medicine into your nose and throat to numb them. This helps prevent coughing and gagging when the bronchoscope (long, thin tube) is inserted.
Next, your doctor will insert the bronchoscope through your nose or mouth, down your throat, and into your airways. As the tube enters your mouth, you may gag a little. Once it enters your throat, that feeling will go away.
Your doctor will look at your vocal cords and airways through the bronchoscope (which has a light and a small camera).
The animation below shows a bronchoscopy procedure. Click the “start” button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.
The animation shows how a doctor inserts a bronchoscope into a patient’s nose and passes it down into the airways. This allows the doctor to look inside the airways.
During the procedure, your doctor may take a sample of lung fluid or tissue for further testing. Samples can be taken using:
•Bronchoalveolar lavage (BRON-ko-al-VE-o-lar la-VAHZH). For this method, your doctor passes a small amount of saline solution (salt water) through the bronchoscope and into part of your lung. He or she then suctions the salt water back out. The fluid picks up cells and bacteria from the airway, which your doctor can study.
•Transbronchial lung biopsy. For this method, your doctor inserts forceps into the bronchoscope and takes a small tissue sample from inside the lung.
•Transbronchial needle aspiration. For this method, your doctor inserts a needle into the bronchoscope and removes cells from the lymph nodes in your lungs. These nodes are small, bean-shaped masses. They trap bacteria and cancer cells and help fight infections.
You may feel short of breath during bronchoscopy, but enough air is getting to your lungs. Your doctor will check your oxygen level. If the level drops, you’ll be given oxygen.
If you have a lot of bleeding in your lungs or a large object stuck in your throat, your doctor may use a bronchoscope with a rigid tube. The rigid tube, which is passed through the mouth, is wider. This allows your doctor to see inside it more easily, treat bleeding, and remove stuck objects.
A rigid bronchoscopy usually is done in a hospital operating room using general anesthesia. The term “anesthesia” refers to a loss of feeling and awareness. General anesthesia temporarily puts you to sleep.
After the procedure is done, your doctor will remove the bronchoscope.
Newer Types of Bronchoscopy
Researchers are studying new types of flexible bronchoscopy. They might make it easier to detect tumors and other lung problems, especially in the lungs’ small airways. These procedures also might make it easier to take fluid and tissue samples from your lungs.
Endobronchial Ultrasound
This procedure is done the same way as a standard flexible bronchoscopy. However, an ultrasound probe is attached to the end of the flexible tube. The probe uses sound waves to create pictures of your lungs. Your doctor can see these pictures on a computer screen.
Fluorescence Bronchoscopy
This procedure also is done the same way as a standard flexible bronchoscopy. However, a fluorescent light is attached to the bronchoscope instead of a white light. Under fluorescent light, tiny tumors look dark red, and healthy tissue looks green.
During the test, your doctor can remove cells from the lymph nodes in your lungs for testing.
Virtual Bronchoscopy
This procedure uses a new method of computed tomography (CT) scan to look inside your lungs. Virtual bronchoscopy uses special x rays to create detailed pictures of your lungs’ airways. A bronchoscope is not used for this procedure.
During the scan, you lie on a table that slides through the center of a tunnel-shaped x-ray machine. X-ray tubes in the scanner rotate around you and take pictures of your lungs and airways.
Source: National Heart Lung and Blood Institute
What To Expect After Bronchoscopy
After bronchoscopy, you’ll need to stay at the hospital or clinic for up to a few hours. If your doctor uses a bronchoscope with a rigid tube, the recovery time is longer. While you’re at the clinic or hospital:
•You may have a chest x ray if your doctor took a sample of lung tissue. This test will check for a pneumothorax and bleeding. A pneumothorax is a condition in which air collects in the space around the lungs. This can cause one or both lungs to collapse.
•A nurse will check your breathing and blood pressure.
•You can’t eat or drink until the numbness in your throat wears off, which will take about 1–2 hours.
After recovery, you’ll need someone to drive you home because you’ll be too sleepy to drive.
If samples of tissue or fluid were taken during the procedure, they’ll be tested in a laboratory (lab). Talk to your doctor about when you’ll get the lab results.
Recovery and Recuperation
Your doctor will let you know when you can return to your normal activities, such as driving, working, and physical activity.
For the first few days, you may have a sore throat, cough, and hoarseness. Call your doctor right away if you:
•Develop a fever
•Have chest pain
•Have trouble breathing
•Cough up more than a few tablespoons of blood
Source: National Heart Lung and Blood Institute
What Does Bronchoscopy Show?
During bronchoscopy, your doctor may see a tumor, signs of an infection, excess mucus in the airways, the site of bleeding, or a blockage in your airway.
Endobronchial ultrasound can show enlarged lymph nodes and tumors in and near the airways. Enlarged lymph nodes can suggest an infection or other problem. The procedure also is used to determine the extent of lung cancer.
Fluorescence bronchoscopy can show an abnormal lesion that can’t be seen with standard flexible bronchoscopy. Some lesions may become cancerous. When lesions are detected early, they may be easier to treat.
Virtual bronchoscopy can show lung problems in the tiny branches of the airways and outside of the airways.
Your doctor will use the results of your bronchoscopy to decide how to treat any lung problems that were found. He or she may recommend other tests or procedures.
Source: National Heart Lung and Blood Institute
What Are the Risks of Bronchoscopy?
Bronchoscopy is a safe procedure, and complications usually are minor. They might include:
•A drop in your oxygen level during the procedure. Your doctor will give you oxygen if this happens.
•Minor bleeding, infection, and fever.
A rare, but more serious risk is a pneumothorax (noo-mo-THOR-aks), or collapsed lung. In this condition, air collects in the space around the lungs, which causes one or both lungs to collapse.
A small pneumothorax might go away on its own. However, if it interferes with breathing, your doctor may use a chest tube to remove the air.
After bronchoscopy, your doctor may suggest that you have a chest x ray to check for complications.
Source: National Heart Lung and Blood Institute
Clinical Trials
The National Heart, Lung, and Blood Institute (NHLBI) is strongly committed to supporting research aimed at preventing and treating heart, lung, and blood diseases and conditions and sleep disorders.
NHLBI-supported research has led to many advances in medical knowledge and care. For example, this research has helped look for better ways to diagnose and evaluate lung problems using procedures such as bronchoscopy.
The NHLBI continues to support research on bronchoscopy. For example, the NHLBI currently sponsors a study to explore how bronchoscopy can help improve the understanding of inflamed airways and asthma.
Much of the NHLBI’s research depends on the willingness of volunteers to take part in clinical trials. Clinical trials test new ways to prevent, diagnose, or treat various diseases and conditions.
For example, new treatments for a disease or condition (such as medicines, medical devices, surgeries, or procedures) are tested in volunteers who have the illness. Testing shows whether a treatment is safe and effective in humans before it is made available for widespread use.
By taking part in a clinical trial, you may gain access to new treatments before they’re widely available. You also will have the support of a team of health care providers, who will likely monitor your health closely. Even if you don’t directly benefit from the results of a clinical trial, the information gathered can help others and add to scientific knowledge.
If you volunteer for a clinical trial, the research will be explained to you in detail. You’ll learn about treatments and tests you may receive, and the benefits and risks they may pose. You’ll also be given a chance to ask questions about the research. This process is called informed consent.
If you agree to take part in the trial, you’ll be asked to sign an informed consent form. This form is not a contract. You have the right to withdraw from a study at any time, for any reason. Also, you have the right to learn about new risks or findings that emerge during the trial.
For more information about clinical trials related to bronchoscopy, talk with your doctor. You also can visit the following Web sites to learn more about clinical research and to search for clinical trials:
•http://clinicalresearch.nih.gov
•www.clinicaltrials.gov
•www.nhlbi.nih.gov/studies/index.htm
•www.researchmatch.org
For more information about clinical trials for children, visit the NHLBI’s Children and Clinical Studies Web page.
Spirometry
Spirometry
Spirometry measures how much air you breathe in and out and how fast you blow it out. This is measured two ways: peak expiratory flow rate (PEFR) and forced expiratory volume in 1 second (FEV1).
PEFR is the fastest rate at which you can blow air out of your lungs. FEV1 refers to the amount of air you can blow out in 1 second.
During the test, a technician will ask you to take a deep breath in. Then, you’ll blow as hard as you can into a tube connected to a small machine. The machine is called a spirometer.
IMAGE
The image shows how spirometry is done. The patient takes a deep breath and blows as hard as possible into a tube connected to a spirometer. The spirometer measures the amount of air breathed out. It also measures how fast the air was blown out.
Your doctor may have you inhale a medicine that helps open your airways. He or she will want to see whether the medicine changes or improves the test results.
Spirometry helps check for conditions that affect how much air you can breathe in, such as pulmonary fibrosis (scarring of the lung tissue). The test also helps detect diseases that affect how fast you can breathe air out, like asthma and COPD (chronic obstructive pulmonary disease).
Tests To Measure Oxygen Level
Pulse oximetry and arterial blood gas tests show how much oxygen is in your blood. During pulse oximetry, a small sensor is attached to your finger or ear. The sensor uses light to estimate how much oxygen is in your blood. This test is painless and no needles are used.For an arterial blood gas test, a blood sample is taken from an artery, usually in your wrist. The sample is sent to a laboratory, where its oxygen level is measured. You may feel some discomfort during an arterial blood gas test because a needle is used to take the blood sample.
Testing in Infants and Young Children
Spirometry and other measures of lung function usually can be done for children older than 6 years, if they can follow directions well. Spirometry might be tried in children as young as 5 years. However, technicians who have special training with young children may need to do the testing.
Instead of spirometry, a growing number of medical centers measure respiratory system resistance. This is another way to test lung function in young children.
The child wears nose clips and has his or her cheeks supported with an adult’s hands. The child breathes in and out quietly on a mouthpiece, while the technician measures changes in pressure at the mouth. During these lung function tests, parents can help comfort their children and encourage them to cooperate.
Very young children (younger than 2 years) may need an infant lung function test. This requires special equipment and medical staff. This type of test is available only at a few medical centers.
The doctor gives the child medicine to help him or her sleep through the test. A technician places a mask over the child’s nose and mouth and a vest around the child’s chest.
The mask and vest are attached to a lung function machine. The machine gently pushes air into the child’s lungs through the mask. As the child exhales, the vest slightly squeezes his or her chest. This helps push more air out of the lungs. The exhaled air is then measured.
In children younger than 5 years, doctors likely will use signs and symptoms, medical history, and a physical exam to diagnose lung problems.
Doctors can use pulse oximetry and arterial blood gas tests for children of all ages.
Source: National Heart Lung and Blood Institute
What To Expect Before Lung Function Tests
If you take breathing medicines, your doctor may ask you to stop them for a short time before spirometry, lung volume measurement, or lung diffusion capacity tests.
No special preparation is needed before pulse oximetry and arterial blood gas tests. If you’re getting oxygen therapy, your doctor may ask you to stop using it for a short time before the tests. This allows your doctor to check your blood oxygen level without the added oxygen.
Source: National Heart Lung and Blood Institute
What To Expect During Lung Function TestsBreathing Tests
Spirometry might be done in your doctor’s office or in a special lung function laboratory (lab). Lung volume measurement and lung diffusion capacity tests are done in a special lab or clinic. For these tests, you sit in a chair next to a machine that measures your breathing. For spirometry, you sit or stand next to the machine.
Before the tests, a technician places soft clips on your nose. This allows you to breathe only through a tube that’s attached to the testing machine. The technician will tell you how to breathe into the tube. For example, you might be asked to breathe normally, slowly, or rapidly.
Some tests require deep breathing, which might make you feel short of breath, dizzy, or light-headed, or it might make you cough.
Spirometry
For this test, you take a deep breath and then exhale as fast and as hard as you can into the tube. With spirometry, your doctor may give you medicine to help open your airways. Your doctor will want to see whether the medicine changes or improves the test results.
Source: National Heart Lung and Blood Institute
What Do Lung Function Tests Show?Breathing Tests
SpirometrySpirometry can show whether you have:
•A blockage (obstruction) in your airways. This may be a sign of asthma, COPD (chronic obstructive pulmonary disease), or another obstructive lung disorder.
•Smaller than normal lungs (restriction). This may be a sign of heart failure, pulmonary fibrosis (scarring of the lung tissue), or another restrictive lung disorder.
Source: National Heart Lung and Blood Institute
What Are the Risks of Lung Function Tests?
Spirometry, lung volume measurement tests, and lung diffusion capacity tests usually are safe. These tests rarely cause problems.
Pulse oximetry has no risks. Side effects from arterial blood gas tests are rare.
Tracheostomy
What Is a Tracheostomy?
A tracheostomy (TRA-ke-OS-to-me) is a surgically made hole that goes through the front of your neck and into your trachea (TRA-ke-ah), or windpipe. The hole is made to help you breathe.
A tracheostomy usually is temporary, although you can have one long term or even permanently. How long you have a tracheostomy depends on the condition that required you to get it and your overall health.
Overview
To understand how a tracheostomy works, it helps to understand how your airways work. The airways carry oxygen-rich air to your lungs. They also carry carbon dioxide, a waste gas, out of your lungs.
The airways include your:
•Nose and linked air passages (called nasal cavities)
•Mouth
•Larynx (LAR-ingks), or voice box
•Trachea, or windpipe
•Tubes called bronchial tubes or bronchi, and their branches
Air enters your body through your nose or mouth. The air travels through your voice box and down your windpipe. The windpipe splits into two bronchi that enter your lungs. (For more information, go to the Health Topics How the Lungs Work article.)
A tracheostomy provides another way for oxygen-rich air to reach your lungs, besides going through your nose or mouth. A breathing tube, also called a trach (trake) tube, is put through the tracheostomy and directly into the windpipe to help you breathe.
Doctors use tracheostomies for many reasons. One common reason is to help people who need to be on ventilators (VEN-til-a-tors) for more than a couple of weeks.
Ventilators are machines that support breathing. If you have a tracheostomy, the trach tube connects to the ventilator.
People who have conditions that interfere with coughing or block the upper airways also may need tracheostomies. Coughing is a natural reflex that protects the lungs. It helps clear mucus (a slimy substance) and bacteria from the airways. A trach tube can be used to help remove, or suction, mucus from the airways.
Doctors also might recommend tracheostomies for people who have swallowing problems due to strokes or other conditions.
Outlook
Creating a tracheostomy is a fairly common, simple procedure. It’s one of the most common procedures for critical care patients in hospitals.
The windpipe is located almost directly under the skin of the neck. So, a surgeon often can create a tracheostomy quickly and easily.
The procedure usually is done in a hospital operating room. However, it also can be safely done at a patient’s bedside. Less often, a doctor or emergency medical technician may do the procedure in a life-threatening situation, such as at the scene of an accident or other emergency.
As with any surgery, complications can occur, such as bleeding, infection, and other serious problems. The risks often can be reduced with proper care and handling of the tracheostomy and the tubes and other related supplies.
Some people continue to need tracheostomies even after they leave the hospital. Hospital staff will teach patients and their families or caregivers how to properly care for their tracheostomies at home.
Source: National Heart Lung and Blood Institute
Other Names for a Tracheostomy
•Trach
•Stoma
Source: National Heart Lung and Blood Institute
Who Needs a Tracheostomy?
People of all ages may need tracheostomies for various reasons.
People Who Are on Ventilators.
A common reason for needing a tracheostomy is the use of a ventilator (VEN-til-a-tor) for more than a couple of weeks.
A ventilator is a machine that supports breathing. It’s connected to a tube that is put through the tracheostomy. This tube often is called a trach tube. The tube carries oxygen-rich air from the ventilator to the lungs.
For people who are on ventilators and awake, a trach tube might be more comfortable than a breathing tube put through the nose or mouth and down into the windpipe. A trach tube also makes it possible for some people who are on ventilators to eat and talk.
Depending on your reason for needing a ventilator, your tracheostomy might be temporary or permanent. If you need a ventilator for the rest of your life, your tracheostomy will likely be permanent.
If your doctor decides that you can stop using the ventilator, you may no longer need the tracheostomy. You can then let the hole close up, either on its own or with surgery.
People Who Have Conditions That Affect Coughing or Block the Airways
Your doctor might recommend a tracheostomy if you have trouble coughing. Coughing is a natural reflex that protects your lungs. It helps clear mucus and bacteria from your airways. If you have trouble coughing, a trach tube can help suction mucus from your airways.
Your doctor also might recommend a tracheostomy if you have a condition that obstructs, or blocks, your upper airways. Examples of diseases, conditions, and other factors that might interfere with coughing or block your upper airways include:
•Congenital defects of the upper airways (in children). “Congenital” means that the defects are present at birth.
•Airway injuries from smoke, steam, or chemical burns.
•Severe allergic reactions or infections.
•Removal of the larynx (for example, from cancer).
•Long-term coma.
•Neuromuscular diseases that paralyze or weaken the muscles and nerves involved in breathing.
•Spinal cord injuries.
Some of these conditions are temporary. Once you recover enough to breathe easily and safely on your own, you may no longer need the tracheostomy. Other conditions may require you to have a tracheostomy long term or even permanently.
People Who Have Swallowing Problems
Your doctor may recommend a tracheostomy if you have trouble swallowing due to a stroke or other condition. You may need the tracheostomy until you can swallow normally again.
Source: National Heart Lung and Blood Institute
What To Expect Before a Tracheostomy
The procedure to make a tracheostomy usually is done in a hospital operating room. However, it also can be safely done at a patient’s bedside.
Rarely, a doctor or emergency medical technician will do the procedure in a life-threatening situation, such as at the scene of an accident or other emergency.
When the procedure is done in a hospital, a general or pediatric surgeon or an otolaryngologist does the surgery. Otolaryngologists specialize in diagnosing and treating problems with the ears, nose, and throat and related structures of the head. These doctors also are called ear, nose, and throat (ENT) doctors.
A pulmonologist or intensive care doctor may help assess your need for a tracheostomy. A pulmonologist specializes in diagnosing and treating lung diseases and conditions.
Often, doctors have to create tracheostomies on short notice, so you have little time to prepare. When possible, the surgical team may request that you fast (not eat anything) for 6–8 hours before the surgery.
If you’re having a tracheostomy procedure, you’ll receive general or local anesthesia (AN-es-THE-ze-ah). The term “anesthesia” refers to a loss of feeling and awareness. General anesthesia temporarily puts you to sleep. Local anesthesia numbs the neck and surrounding area.
Source: National Heart Lung and Blood Institute
What To Expect During a Tracheostomy
To create a tracheostomy, your surgeon will make a cut through the lower front part of your neck. He or she will then make a cut in your trachea, or windpipe.
The surgeon will place a tube (called a trach tube) through the hole and into the windpipe. The tube will help keep the hole open. Some trach tubes are “cuffed.” Doctors can widen or narrow cuffed tubes by inflating or deflating them with air.
You may have a chest x ray to ensure the trach tube is placed correctly. The tube will then be held in place with stitches, surgical tape, or a Velcro band.
The procedure to make a tracheostomy usually takes between 20 and 45 minutes.
Tracheostomy
IMAGE
Figure A shows a side view of the neck and the correct placement of a trach tube in the trachea, or windpipe. Figure B shows an external view of a patient who has a tracheostomy.
Source: National Heart Lung and Blood Institute
What To Expect After a Tracheostomy
Depending on your overall health, you may stay in the hospital for 3–10 days or more after getting a tracheostomy. It can take up to 2 weeks for a tracheostomy to fully form, or mature.
You might be sedated during your recovery. This means that you’ll be given medicine to help you relax. The medicine might make you sleepy.
Eating
Until the tracheostomy is mature, you won’t be able to eat normally. Instead of food, you may receive nutrients through an intravenous (IV) line inserted into a vein in your body. Or, you may get food through a feeding tube.
The feeding tube is placed through your nose or mouth and guided to your stomach. If you’ll be on a ventilator for a long time, the tube might be placed directly into your stomach or small intestine through a surgically made hole.
After the tracheostomy has matured, you’ll likely work with a speech therapist to regain your ability to swallow normally. You may have swallowing tests to show whether you can swallow safely. If you can, you might be able to start eating normally again.
Communicating
You won’t be able to talk right after the procedure. Even after the tracheostomy has matured, you’ll still have trouble speaking. The trach tube interferes with the normal voice process. It prevents air from the lungs from flowing over the voice box.
However, once your tracheostomy has matured, a speech therapist or other health professional will show you ways in which you can use your voice to speak clearly.
One option is a speaking valve that attaches to the trach tube. The valve lets air enter the tracheostomy, pass into the windpipe and up over the voice box, and then exit the mouth or nose.
Certain types of cuffed trach tubes also can help you speak. Doctors can widen or narrow cuffed tubes by inflating or deflating the cuffed part with air.
If you’re using a ventilator, for example, the cuffed tube is inflated to fill the width of the airway. If you aren’t using a ventilator, the tube can be deflated. This allows some air to enter the windpipe and pass over the voice box.
Other Concerns
If you no longer need the tracheostomy, your doctor will remove your trach tube. The hole should close up on its own fairly quickly.
If the hole doesn’t close on its own, you may need surgery to close it. A small scar will remain at the site of the tracheostomy.
Source: National Heart Lung and Blood Institute
What Are the Risks of a Tracheostomy?
As with any surgery, a tracheostomy procedure can cause complications. Some complications are more likely to occur soon after the procedure is done. Others are more likely to happen over time.
Some complications are related to the tube that is put through the tracheostomy into the windpipe (the trach tube).
Proper care and handling of the tracheostomy and the tubes and other related supplies can help reduce risks.
Immediate Complications
Complications that can occur shortly after surgery include:
•Bleeding and infection.
•Pneumothorax (noo-mo-THOR-aks). This is a condition in which air or gas builds up in the space between the lungs and chest wall. Pneumothorax can cause sudden pain in one side of the lung and shortness of breath. The condition also can put pressure on the lung and cause it to collapse.
•Subcutaneous emphysema (sub-ku-TA-ne-us em-fi-SE-ma). This is a condition in which air gets trapped beneath the skin.
Later Complications
Over time, other complications can develop. For example, infections may scar the windpipe. A fistula (FIS-tu-lah), or abnormal connection, may form between the windpipe and esophagus. (The esophagus is the passage leading from your mouth to your stomach.)
A fistula between the windpipe and esophagus can cause food and saliva to enter the lungs and possibly cause pneumonia. Symptoms of a fistula include severe coughing and trouble breathing.
Trach Tube Complications
Some complications are related to the trach tube. For example, the tube may slip or fall out of the tracheostomy. Other problems include:
•Abnormal tissue masses, or granulations (GRAN-u-LA-shuns), in the airways
•Narrowing or collapse of the airway above the trach tube’s location
•Irritation of the windpipe’s inside lining from the tube rubbing against the lining’s surface
•Blockage of the tracheostomy from dried secretions and mucus masses (also called plugs)
•Infection
•Failure of the tracheostomy to close on its own after the trach tube is removed
Source: National Heart Lung and Blood Institute
Living with a Tracheostomy
You may still need a tracheostomy after you leave the hospital. If so, hospital staff will show you and your family or caregiver how to care for the tracheostomy at home.
Proper care and handling of the tracheostomy and the tubes and other related supplies can help reduce the risk of complications, such as infection.
You’ll learn how to clean the tracheostomy site, change your trach tube, suction your airways using the trach tube, and work with a home care service.
Home care services allow people who have special needs to stay in their homes. Home care services may provide medical equipment, visits from health care professionals, and help giving medicines. This service also may help with routine care of your tracheostomy.
Before you leave the hospital, you’ll also learn about signs and symptoms of possible complications. Your doctor will let you know when you should call him or her and when to seek emergency care.
After you leave the hospital, you’ll need ongoing care with your doctor. This will allow your doctor to monitor your health and check for possible problems.
Source: National Heart Lung and Blood Institute
Clinical Trials
The National Heart, Lung, and Blood Institute (NHLBI) is strongly committed to supporting research aimed at preventing and treating heart, lung, and blood diseases and conditions and sleep disorders.
NHLBI-supported research has led to many advances in medical knowledge and care. Often, these advances depend on the willingness of volunteers to take part in clinical trials.
Clinical trials test new ways to prevent, diagnose, or treat various diseases and conditions. For example, new treatments for a disease or condition (such as medicines, medical devices, surgeries, or procedures) are tested in volunteers who have the illness. Testing shows whether a treatment is safe and effective in humans before it is made available for widespread use.
By taking part in a clinical trial, you can gain access to new treatments before they’re widely available. You also will have the support of a team of health care providers, who will likely monitor your health closely. Even if you don’t directly benefit from the results of a clinical trial, the information gathered can help others and add to scientific knowledge.
If you volunteer for a clinical trial, the research will be explained to you in detail. You’ll learn about treatments and tests you may receive, and the benefits and risks they may pose. You’ll also be given a chance to ask questions about the research. This process is called informed consent.
If you agree to take part in the trial, you’ll be asked to sign an informed consent form. This form is not a contract. You have the right to withdraw from a study at any time, for any reason. Also, you have the right to learn about new risks or findings that emerge during the trial.
For more information about clinical trials related to tracheostomies, talk with your doctor. You also can visit the following Web sites to learn more about clinical research and to search for clinical trials:
•http://clinicalresearch.nih.gov
•www.clinicaltrials.gov
•www.nhlbi.nih.gov/studies/index.htm
•www.researchmatch.org
For more information about clinical trials for children, visit the NHLBI’s Children and Clinical Studies Web page.
Source: National Heart Lung and Blood Institute
Sleep Studies
What Are Sleep Studies?
Sleep studies are tests that measure how well you sleep and how your body responds to sleep problems. These tests can help your doctor find out whether you have a sleep disorder and how severe it is.
Sleep studies are important because untreated sleep disorders can raise your risk for heart disease, high blood pressure, stroke, and other medical conditions. Sleep disorders also have been linked to an increased risk of injury, such as falling (in the elderly) and car accidents.
People usually aren’t aware of their breathing and movements while sleeping. They may never think to talk to their doctors about issues that might be related to sleep problems.
However, sleep disorders can be treated. Talk with your doctor if you snore regularly or feel very tired while at work or school most days of the week.
You also may want to talk with your doctor if you often have trouble falling or staying asleep, or if you wake up too early and aren’t able to go back to sleep. These are common signs of a sleep disorder.
Your doctor might be able to diagnose a sleep disorder based on your sleep schedule and habits. However, he or she also might need the results from sleep studies and other medical tests to diagnose a sleep disorder.
Sleep studies can help diagnose:
- Sleep-related breathing disorders, such as sleep apnea
- Sleep-related seizure disorders
- Sleep-related movement disorders, such as periodic limb movement disorder
- Sleep disorders that cause extreme daytime tiredness, such as narcolepsy
- Doctors might use sleep studies to help diagnose or rule out restless legs syndrome (RLS). However, RLS usually is diagnosed based on signs and symptoms, medical history, and a physical exam.
You can find more information about sleep and sleep disorders in the National Heart, Lung, and Blood Institute’s “Your Guide to Healthy Sleep.”
Source: National Heart Lung and Blood Institute
Types of Sleep Studies
To diagnose sleep-related problems, doctors may use one or more of the following sleep studies:
- Polysomnogram (pol-e-SOM-no-gram), or PSG
- Multiple sleep latency test, or MSLT
- Maintenance of wakefulness test, or MWT
- Home-based portable monitor
- Your doctor may use actigraphy if he or she thinks you have a circadian (ser-KA-de-an) rhythm disorder. This is a disorder that disrupts your body’s natural sleep–wake cycle.
Polysomnogram
For a PSG, you usually will stay overnight at a sleep center. This study records brain activity, eye movements, heart rate, and blood pressure.
A PSG also records the amount of oxygen in your blood, air movement through your nose while you breathe, snoring, and chest movements. The chest movements show whether you’re making an effort to breathe.
PSG results are used to help diagnose:
- Sleep-related breathing disorders, such as sleep apnea
- Sleep-related seizure disorders
- Sleep-related movement disorders, such as periodic limb movement disorder
- Sleep disorders that cause extreme daytime tiredness, such as narcolepsy (PSG and MSLT results will be reviewed together)
- Your doctor also may use a PSG to find the right setting for you on a CPAP (continuous positive airway pressure) machine. CPAP is a treatment for sleep apnea.
Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. In obstructive sleep apnea, the airway collapses or becomes blocked during sleep. A CPAP machine uses mild air pressure to keep your airway open while you sleep.
If your doctor thinks that you have sleep apnea, he or she might schedule a split-night sleep study. During the first half of the night, your sleep is checked without a CPAP machine. This will show whether you have sleep apnea and how severe it is.
If the PSG shows that you have sleep apnea, you’ll use a CPAP machine during the second half of the split-night study. A technician will help you select a CPAP mask that fits and is comfortable.
While you sleep, the technician will check the amount of oxygen in your blood and whether your airway stays open. He or she will adjust the flow of air through the mask to find the setting that’s right for you. This process is called CPAP titration.
Sometimes the entire study isn’t done during the same night. Some people need to go back to the sleep center for the CPAP titration study.
Also, some people might need more than one PSG. For example, your doctor may recommend a followup PSG to:
- Adjust your CPAP settings after weight loss or weight gain
- Recheck your sleep if symptoms return despite treatment with CPAP
- Find out how well surgery has worked to correct a sleep-related breathing disorder
- Multiple Sleep Latency Test
This daytime sleep study measures how sleepy you are. It typically is done the day after a PSG. You relax in a dark, quiet room for about 30 minutes while a technician checks your brain activity.
The MSLT records whether you fall asleep during the test and what types and stages of sleep you’re having. Sleep has two basic types: rapid eye movement (REM) and non-REM. Non-REM sleep has three distinct stages. REM sleep and the three stages of non-REM sleep occur in regular cycles throughout the night.
The types and stages of sleep you have can help your doctor diagnose sleep disorders such as narcolepsy, idiopathic hypersomnia (id-ee-o-PATH-ick HI-per-SOM-ne-ah), and other sleep disorders that cause daytime tiredness.
An MSLT takes place over the course of a full day. This is because your ability to fall asleep changes throughout the day.
Maintenance of Wakefulness Test
This daytime sleep study measures your ability to stay awake and alert. It’s usually done the day after a PSG and takes most of the day.
Results can show whether your inability to stay awake is a public or personal safety concern. Results also can show how you’re responding to treatment.
Home-Based Portable Monitor
Your doctor may recommend a home-based sleep test with a portable monitor. The portable monitor will record some of the same information as a PSG. For example, it may record:
- The amount of oxygen in your blood
- Air movement through your nose while you breathe
- Your heart rate
- Chest movements that show whether you’re making an effort to breathe
- A sleep specialist might use the results from a home-based sleep test to help diagnose sleep apnea. He or she also might use the results to see how well some treatments for sleep apnea are working.
Home-based testing is appropriate only for some people. Talk with your doctor to find out whether a portable monitor is an option for you. If your doctor recommends this test, you’ll need to visit a sleep center or your doctor’s office to pick up the equipment and learn how to use it.
If you’re diagnosed with sleep apnea, your doctor may prescribe treatment with CPAP. If so, he or she will need to find the correct airflow setting for your CPAP machine. To do this, you may need to go to a sleep center to have a PSG. Or, you may be able to find the correct setting at home with an autotitrating CPAP machine.
An autotitrating CPAP machine automatically finds the right airflow setting for you. These machines work well for some people who have sleep apnea. A technician or a doctor will teach you how to use the machine.
Actigraphy
Actigraphy is a test that’s done while you do your normal daily routine. This test is useful for all age groups and doesn’t require an overnight stay at a sleep center.
An actigraph is a simple device that’s usually worn like a wristwatch. Your doctor may ask you to wear the device for several days and nights, except when bathing or swimming.
Actigraphy gives your doctor a better idea about your sleep schedule, such as when you sleep or nap and whether the lights are on while you sleep.
Doctors can use actigraphy to help diagnose many sleep disorders, including circadian rhythm disorders (such as jet lag and shift work disorder). Doctors also may use the test to check how well sleep treatments are working.
Actigraphy might be used with a PSG or alone.
Source: National Heart Lung and Blood Institute
Who Needs a Sleep Study?
Your doctor might not detect a sleep problem during a routine office visit because you’re awake. Thus, you should let your doctor know if you or a family member/sleep partner thinks you might have a sleep problem.
For example, talk with your doctor if you:
- Have chronic (ongoing) snoring
- Often feel sleepy during the day, even though you’ve spent enough time in bed to be well rested
- Don’t wake up feeling refreshed and alert
- Have trouble adapting to shift work
- Your doctor might be able to diagnose a sleep disorder based on your sleep schedule and habits. However, he or she also might need the results from sleep studies and other medical tests to diagnose a sleep disorder.
Sleep studies often are used to diagnose sleep-related breathing disorders, such as sleep apnea. Signs of these disorders include loud snoring, gasping, or choking sounds while you sleep or pauses in breathing during sleep.
Other common signs and symptoms of sleep disorders include the following:
- It takes you more than 30 minutes to fall asleep at night.
- You often wake up during the night and then have trouble falling asleep again, or you wake up too early and aren’t able to go back to sleep.
- You feel sleepy during the day and fall asleep within 5 minutes if you have a chance to nap, or you fall asleep at inappropriate times during the day.
- You have creeping, tingling, or crawling feelings in your legs that you can relieve by moving or massaging them, especially in the evening and when you try to fall asleep.
- You have vivid, dreamlike experiences while falling asleep or dozing.
- You have episodes of sudden muscle weakness when you’re angry, fearful, or when you laugh.
- You feel as though you can’t move when you first wake up.
- Your bed partner notes that your legs or arms jerk often during sleep.
- You regularly feel the need to use stimulants, such as caffeine, to stay awake during the day.
- Many of the same signs and symptoms of sleep disorders can occur in infants and children. If your child snores or has other signs or symptoms of sleep problems, talk with his or her doctor.
If you’ve had a sleep disorder for a long time, you may not notice how it affects your daily routine. Using a sleep diary, such as the one found in “Your Guide to Healthy Sleep,” might be helpful.
Your doctor will work with you to decide whether you need a sleep study. A sleep study allows your doctor to observe sleep patterns and diagnose a sleep disorder, which can then be treated.
Certain medical conditions have been linked to sleep disorders, such as heart failure, kidney disease, high blood pressure, diabetes, stroke, obesity, and depression.
If you have or have had one of these conditions, ask your doctor whether it would be helpful to have a sleep study.
Source: National Heart Lung and Blood Institute
What To Expect Before a Sleep Study
Before a sleep study, your doctor may ask you about your sleep habits and whether you feel well rested and alert during the day.
Your doctor also may ask you to keep a sleep diary. You’ll record information such as when you went to bed, when you woke up, how many times you woke up during the night, and more.
You can find a sample sleep diary in the National Heart, Lung, and Blood Institute’s “Your Guide to Healthy Sleep.”
What To Bring With You
- Depending on what type of sleep study you’re having, you may need to bring:
- Notes from your sleep diary. These notes may help your doctor.
- Pajamas and a toothbrush for overnight sleep studies.
- A book or something to do between testing periods if you’re having a maintenance of wakefulness test (MWT) or multiple sleep latency test (MSLT).
How To Prepare
Your doctor may advise you to stop or limit the use of tobacco, caffeine, and other stimulants before having a sleep study.
Your doctor also may ask whether you’re taking any medicines. Make sure you tell your doctor about all of the medicines you’re taking, including over-the-counter products. Some medicines can affect the sleep study results.
Your doctor also may ask about any allergies you have.
You should try to sleep well for 2 nights before having a sleep study. If you’re being tested as a requirement for a transportation- or safety-related job, you might be asked to take a drug-screening test.
If you’re going to have a home-based sleep test with a portable monitor, you’ll need to visit a sleep center or your doctor’s office to pick up the equipment. Your doctor or a technician will show you how to use the equipment.
Source: National Heart Lung and Blood Institute
What To Expect During a Sleep Study
Sleep studies are painless. The polysomnogram (PSG), multiple sleep latency test (MSLT), and maintenance of wakefulness test (MWT) usually are done at a sleep center.
The room the sleep study is done in may look like a hotel room. A technician makes the room comfortable for you and sets the temperature to your liking.
Most of your contact at the sleep center will be with nurses or technicians. They can answer questions about the test itself, but they usually can’t give you the test results.
During a Polysomnogram
Sticky patches with sensors called electrodes are placed on your scalp, face, chest, limbs, and a finger. While you sleep, these sensors record your brain activity, eye movements, heart rate and rhythm, blood pressure, and the amount of oxygen in your blood.
Elastic belts are placed around your chest and belly. They measure chest movements and the strength and duration of inhaled and exhaled breaths.
Wires attached to the sensors transmit the data to a computer in the next room. The wires are very thin and flexible. They are bundled together so they don’t restrict movement, disrupt your sleep, or cause other discomfort.
The image shows the standard setup for a polysomnogram. In figure A, the patient lies in a bed with sensors attached to the body. In figure B, the polysomnogram recording shows the blood oxygen level, breathing event, and rapid eye movement (REM) sleep stage over time.
If you have signs of sleep apnea, you may have a split-night sleep study. During the first half of the night, the technician records your sleep patterns. At the start of the second half of the night, he or she wakes you to fit a CPAP (continuous positive airway pressure) mask over your nose and/or mouth.
A small machine gently blows air through the mask. This creates mild pressure that keeps your airway open while you sleep.
The technician checks how you sleep with the CPAP machine. He or she adjusts the flow of air through the mask to find the setting that’s right for you.
At the end of the PSG, the technician removes the sensors. If you’re having a daytime sleep study, such as an MSLT, some of the sensors might be left on for that test.
Parents usually are required to spend the night with their child during the child’s PSG.
During a Multiple Sleep Latency Test
The MSLT is a daytime sleep study that’s usually done after a PSG. This test often involves sensors placed on your scalp, face, and chin. These sensors record brain activity and eye movements. They show various stages of sleep and how long it takes you to fall asleep. Sometimes your breathing is checked during an MSLT.
A technician in another room watches these recordings as you sleep. He or she fixes any problems that occur with the recordings.
About 2 hours after you wake from the PSG, you’re asked to relax and try to fall asleep in a dark, quiet room. The test is repeated four or five times throughout the day. This is because your ability to fall asleep changes throughout the day.
You get 2-hour breaks between tests. You need to stay awake during the breaks.
The MSLT records whether you fall asleep during the test and what types and stages of sleep you have. Sleep has two basic types: rapid eye movement (REM) and non-REM. Non-REM sleep has three distinct stages. REM sleep and the three stages of non-REM sleep occur in regular cycles throughout the night.
The types and stages of sleep you have during the day can help your doctor diagnose sleep disorders such as narcolepsy, idiopathic hypersomnia, and other sleep disorders that cause daytime tiredness.
During a Maintenance of Wakefulness Test
This sleep study usually is done the day after a PSG, and it takes most of the day. Sensors on your scalp, face, and chin are used to measure when you’re awake and asleep.
You sit quietly on a chair in a comfortable position and look straight ahead. Then you simply try to stay awake for a period of time.
An MWT typically includes four trials lasting about 40 minutes each. If you fall asleep, the technician will wake you after about 90 seconds. There usually are 2-hour breaks between trials. During these breaks, you can read, watch television, etc.
If you’re being tested as a requirement for a transportation- or safety-related job, you may need a drug-screening test before an MWT.
During a Home-Based Portable Monitor Test
If you’re having a home-based portable monitor test, you’ll need to set up the equipment at home before you go to sleep.
When you pick up the equipment at the sleep center or your doctor’s office, someone will show you how to use it. In some cases, a technician will come to your home to help you prepare for the study.
During Actigraphy
You don’t have to go to a sleep center for this test. An actigraph is a small device that’s usually worn like a wristwatch. You can do your normal daily routine while you wear it. You remove it while bathing or swimming.
The actigraph measures your sleep–wake behavior over 3 to 14 days and nights. Results give your doctor a better idea about your sleep habits, such as when you sleep or nap and whether the lights are on while you sleep.
Your doctor may ask you to keep a sleep diary while you wear an actigraph. You can find a sample sleep diary in the National Heart, Lung, and Blood Institute’s “Your Guide to Healthy Sleep.”
Source: National Heart Lung and Blood Institute
What To Expect After a Sleep Study
Once the sensors are removed after a polysomnogram (PSG), multiple sleep latency test, or maintenance of wakefulness test, you can go home. If you used an actigraph or a home-based portable monitor, you’ll return the equipment to a sleep center or your doctor’s office.
You won’t receive a diagnosis right away. A sleep specialist and your primary care doctor will review the results of your sleep study. They will use your medical history, your sleep history, and the test results to make a diagnosis.
You may not get the sleep study results for a couple of weeks. Usually, your doctor, nurse, or sleep specialist will explain the test results and work with you to develop a treatment plan.
Source: National Heart Lung and Blood Institute
What Do Sleep Studies Show?
Sleep studies allow doctors to look at sleep patterns and note sleep-related problems that patients don’t know about or can’t describe during routine office visits. Sleep studies are needed to diagnose certain sleep disorders, such as sleep apnea and narcolepsy.
Your sleep study results might include information about sleep and wake times, sleep stages, abnormal breathing, the amount of oxygen in your blood, and any movement during sleep.
Your doctor will use your sleep study results and your medical history to make a diagnosis and create a treatment plan.
Results From a Polysomnogram
Polysomnogram (PSG) results are used to help diagnose:
- Sleep-related breathing disorders, such as sleep apnea
- Sleep-related seizure disorders
- Sleep-related movement disorders, such as periodic limb movement disorder
- Sleep disorders that cause extreme daytime tiredness, such as narcolepsy (PSG and MSLT results will be reviewed together)
- If you have sleep apnea, your doctor also may use a PSG to find the correct setting for you on a CPAP (continuous positive airway pressure) machine.
A CPAP machine supplies air to your nose and/or mouth through a special mask. Finding the right setting involves adding just enough extra air to create mild pressure that keeps your airway open while you sleep.
Your doctor may recommend a followup PSG to:
- Adjust your CPAP settings after weight loss or weight gain
- Recheck your sleep if symptoms return despite treatment with CPAP
- Find out how well surgery has worked to correct a sleep-related breathing disorder
- Technicians also use PSGs to record the number of abnormal breathing events that occur with sleep-related breathing disorders, such as sleep apnea. These events include pauses in breathing or dips in the level of oxygen in your blood.
Results From a Multiple Sleep Latency Test
MSLT results are used to help diagnose narcolepsy, idiopathic hypersomnia, and other sleep disorders that cause daytime sleepiness.
For narcolepsy, technicians study how quickly you fall asleep. The MSLT also shows how long it takes you to reach different types and stages of sleep.
Sleep has two basic types: rapid eye movement (REM) and non-REM. Non-REM sleep has three distinct stages. REM sleep and the three stages of non-REM sleep occur in regular cycles throughout the night.
People who fall asleep in less than 5 minutes or quickly reach REM sleep may need treatment for a sleep disorder.
Results From a Maintenance of Wakefulness Test
Maintenance of wakefulness test (MWT) results can show whether your inability to stay awake is a public or personal safety concern. This study also is used to show how well treatment for a sleep disorder is working.
Results From a Home-Based Portable Monitor Test
Home-based portable monitors might be used to help diagnose sleep apnea. Portable monitors also can show how well some treatments for sleep apnea are working.
Sometimes, home-based monitors don’t record enough information. If this happens, you might have to take the monitor home again and repeat the test, or your sleep specialist may ask you to have a PSG.
Results From Actigraphy
Actigraphy results give your doctor a better idea about your sleep habits, such as when you sleep or nap and whether the lights are on while you sleep. This test also is used to help diagnose circadian rhythm disorders.
Source: National Heart Lung and Blood Institute
What Are the Risks of Sleep Studies?
Sleep studies are painless. There’s a small risk of skin irritation from the sensors. The irritation will go away once the sensors are removed.
Although the risks of sleep studies are minimal, these studies take time (at least several hours). If you’re having a daytime sleep study, bring a book or something to do during the test.
Source: National Heart Lung and Blood Institute
Clinical Trials
The National Heart, Lung, and Blood Institute (NHLBI) is strongly committed to supporting research aimed at preventing and treating heart, lung, and blood diseases and conditions and sleep disorders.
NHLBI-supported research has led to many advances in medical knowledge and care. For example, this research has uncovered some of the causes of various sleep disorders and ways to diagnose and treat these disorders.
The NHLBI continues to support research aimed at learning more about sleep and sleep disorders. In November 2011, the National Institutes of Health (NIH) released its “2011 NIH Sleep Disorders Research Plan.”
The plan expands upon previous and current research programs and identifies new research opportunities. The NHLBI’s National Center on Sleep Disorders Research will coordinate this research across the NIH and other Federal agencies.
The research will focus on sleep and the body’s natural 24-hour cycle, the role of genes and the environment on sleep health, and ways to improve the prevention, diagnosis, and treatment of sleep disorders.
Much of this research depends on the willingness of volunteers to take part in clinical trials. Clinical trials test new ways to prevent, diagnose, or treat various diseases, conditions, and health problems.
For example, new treatments for a disease or condition (such as medicines, medical devices, surgeries, or procedures) are tested in volunteers who have the illness. Testing shows whether a treatment is safe and effective in humans before it is made available for widespread use.
By taking part in a clinical trial, you may gain access to new treatments before they’re widely available. You also will have the support of a team of health care providers, who will likely monitor your health closely. Even if you don’t directly benefit from the results of a clinical trial, the information gathered can help others and add to scientific knowledge.
If you volunteer for a clinical trial, the research will be explained to you in detail. You’ll learn about treatments and tests you may receive, and the benefits and risks they may pose. You’ll also be given a chance to ask questions about the research. This process is called informed consent.
If you agree to take part in the trial, you’ll be asked to sign an informed consent form. This form is not a contract. You have the right to withdraw from a study at any time, for any reason. Also, you have the right to learn about new risks or findings that emerge during the trial.
For more information about clinical trials related to sleep studies or sleep disorders, talk with your doctor. You also can visit the following Web sites to learn more about clinical research and to search for clinical trials:
http://clinicalresearch.nih.gov
www.clinicaltrials.gov
www.nhlbi.nih.gov/studies/index.htm
www.researchmatch.org
For more information about clinical trials for children, visit the NHLBI’s Children and Clinical Studies Web page.