If you’ve been struggling with sleep—waking up feeling exhausted, snoring so loudly that your partner threatens to sleep in another room, or experiencing unexplained fatigue despite getting a full night’s rest—you might have considered a sleep study.
But what actually happens during a sleep study? More importantly, who really needs one? There’s a common misconception that sleep studies are for anyone with sleep troubles, including those with insomnia. In reality, sleep labs are mainly used to diagnose sleep apnea and other conditions where breathing or movement disrupt sleep. If insomnia is your main issue, a sleep study probably isn’t the right place to start.
Let’s break down what happens during a sleep study, what it can reveal, and when it makes sense to schedule one.
What Happens During a Sleep Study?
A sleep study, or polysomnography, is an overnight test usually conducted in a specialized sleep lab. The goal is to monitor your body while you sleep to detect abnormal breathing patterns, unusual movements, or other disruptions.
Step 1: Arriving at the Sleep Lab
Most sleep studies happen in a dedicated sleep center that’s designed to feel like a bedroom rather than a hospital room. You typically arrive in the evening, bringing your pajamas and anything else you need for a normal night’s sleep.
A sleep technician will greet you and explain the process. They’ll then attach several sensors to your body, including:
Scalp and face
– To monitor brain waves and eye movements, helping determine sleep stages.
Chest
– To track heart rate and breathing.
Legs
– To detect movements, which can indicate restless legs or periodic limb movement disorder.
Finger
– A pulse oximeter measures oxygen levels to check for drops due to breathing issues.
While it might feel strange to sleep with all these wires attached, they’re painless and lightweight. Most people adjust fairly quickly.
Step 2: Sleeping While Monitored
Once you’re all set up, the lights go out, and you try to sleep as normally as possible. A technician monitors your sleep from another room, watching for any interruptions in breathing, abnormal movements, or other unusual activity.
If sleep apnea is suspected, the study tracks how many times per hour your breathing stops or becomes shallow. If your breathing is severely disrupted, the technician may wake you up and have you wear a CPAP (Continuous Positive Airway Pressure) mask
to see if it helps.
Step 3: Waking Up and Reviewing the Data
In the morning, the sensors are removed, and you’re free to go home. A sleep specialist later analyzes the data and determines whether you have a sleep disorder like
sleep apnea, restless leg syndrome, or REM sleep behavior disorder.
What Can a Sleep Study Reveal?
1. The Big One: Sleep Apnea (The Most Common Reason for a Sleep Study)
If you snore loudly, gasp for air during sleep, or feel exhausted even after a full night’s rest, you might have sleep apnea.
Example:
Mark, a 45-year-old office worker, always felt drained during the day, despite sleeping 7–8 hours a night. His wife mentioned that he snored loudly and sometimes seemed to stop breathing in his sleep. A sleep study revealed that he had severe obstructive sleep apnea, with his breathing stopping nearly 30 times per hour. He started using a CPAP machine, and within weeks, he felt more energetic and alert.
A sleep study can determine the Apnea-Hypopnea Index (AHI), which measures how often breathing stops per hour:
Mild Sleep Apnea: 5–15 events per hour (Mild is actually not that mild!!!)
Moderate Sleep Apnea: 15–30 events per hour
Severe Sleep Apnea: 30+ events per hour
If diagnosed, treatment options can include CPAP therapy, weight loss, positional therapy, or even surgery in severe cases.
2. Periodic Limb Movement Disorder (PLMD) and Restless Leg Syndrome (RLS)
Some people experience involuntary leg movements during sleep, leading to frequent awakenings. A sleep study can detect Periodic Limb Movement Disorder (PLMD) , which is different from Restless Leg Syndrome (RLS) (which causes discomfort before bedtime).
Example:
Susan, a 60-year-old retired teacher, kept waking up at night without knowing why. A sleep study showed that her legs twitched every 30 seconds throughout the night, disrupting her sleep cycle. Her doctor prescribed treatment, and her sleep improved significantly.
3. REM Sleep Behavior Disorder (Acting Out Dreams)
Normally, during REM (Rapid Eye Movement) sleep, your body is temporarily paralyzed to prevent you from acting out dreams. But in REM Sleep Behavior Disorder (RBD) , this paralysis doesn’t work, leading to talking, kicking, or even punching while dreaming. A sleep study can confirm if muscle activity is occurring during REM sleep, helping diagnose this rare but serious condition.
What a Sleep Study Can’t Diagnose: Insomnia
Here’s a really important point:
You can’t diagnose insomnia with a sleep study.
Insomnia is about struggling to fall asleep, stay asleep, or waking up too early — but these issues aren’t usually tied to anything a sleep study would catch. You could lie in bed for hours in a sleep lab, unable to sleep, but that doesn’t tell doctors why you can’t sleep.
Instead, insomnia is usually best treated with Cognitive Behavioral Therapy for Insomnia (CBT-I) — a structured, short-term therapy that works better than sleeping pills and has longer-lasting effects. So if your main issue is "I can't fall asleep" or "I wake up and can't go back to sleep," a sleep study probably isn’t where you should start.
What to Do Instead for Insomnia:
If you’re dealing with persistent insomnia, the best first step isn’t a sleep lab or even sleep medication. Instead, Cognitive Behavioral Therapy for Insomnia (CBT-I) is the gold-standard treatment. Make a consultation call here, as I work with people with insomnia in more than 40 states:
Example:
Jake, a 35-year-old engineer, had trouble falling asleep for months. He considered a sleep study, but his doctor explained that since he wasn’t snoring or experiencing breathing issues, a sleep lab wouldn’t help. Instead, he tried CBT-I with Dr. Joshua Tal,
which helped him change his sleep habits and reduce anxiety about sleep. Within a 5 treatment sessions over 6 weeks, his insomnia improved without needing medication.
When Should You Get a Sleep Study?
You should consider a sleep study if you experience:
✔ Loud snoring with gasping or choking sounds
✔ Severe daytime fatigue despite 7+ hours of sleep
✔ Frequent nighttime awakenings with no clear cause
✔ Unusual movements or behaviors during sleep
You don’t need a sleep study if:
❌ Your main issue is trouble falling asleep (insomnia)
❌ You wake up feeling tired but don’t snore or have breathing issues
❌ You think you need sleeping pills (CBT-I is a better first step)
Final Thoughts
A sleep study is a powerful tool for diagnosing sleep apnea, restless leg syndrome, and other sleep disorders, but it’s not the answer for insomnia. If you’re struggling with fatigue and snoring, a sleep study could help uncover the cause. But if your issue is simply falling asleep, CBT-I—not a sleep lab—is the best place to start.
If you’re unsure, talk to a doctor to see if a sleep study is right for you. Better sleep could be just one test—or even one behavioral change—away! 😊
This answer is not a substitute for professional medical advice. This answer is for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment.
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