How to Start a Sleep Lab in Your Hospital or Clinic
Most people who ask us how to start a sleep lab begin with the equipment. We suggest starting one step earlier, with the studies you want to offer and who will report them. Get those right and the room, the machines and the staff follow. This guide covers what we go through with a hospital or pulmonologist planning a sleep lab or sleep clinic: study levels, the room and monitoring station, equipment, staffing, AASM scoring, referrals, home testing, and CPAP and BiPAP follow-up.
Start with the studies you will offer, not the room
The level of study decides almost everything else. A home testing service for suspected sleep apnea needs polygraphs, a coordinator and a reporting physician, and can begin before any room is ready. An attended in-lab service needs a dedicated sleep room, a monitoring station, night-shift technicians and a full PSG system. Plenty of centres begin with the first and add the second once referrals are steady.
The levels themselves, and how the choice moves the equipment budget, are explained on our polysomnography machine price page.
Home sleep apnea testing (Level 3)
Breathing, effort, oxygen, pulse and position, recorded at home on a polygraph. No lab room needed. The lowest-cost way to begin, and enough for most patients referred with suspected obstructive sleep apnea.
SAMOA or ScalaAttended in-lab PSG (Level 1)
Full polysomnography with EEG, EOG, EMG and ECG, watched by a technician overnight. Needed for complex sleep apnea, suspected narcolepsy, parasomnias, limb movements and nocturnal seizures.
SonataHome PSG (Level 2)
A full PSG recorded without a technician in the room. Useful when you need EEG but the patient cannot stay overnight in hospital.
SonataCPAP / BiPAP titration
An overnight study in the lab where the technician adjusts therapy pressure while the PSG records. Most labs add this once they are diagnosing apnea regularly.
prismaLAB with SonataSleep lab layout: the patient room and the monitoring station
A sleep lab is, at its simplest, a bedroom that records and a control room that watches. Keep them apart. Each time a technician walks in to fix a sensor, the patient wakes, and a lab that is too bright, noisy or clinical gives you a night of poor sleep that does not represent the patient’s usual night.
Patient room
- Quiet, with lighting you can fully control
- A comfortable bed, not a ward trolley
- Steady room temperature
- Camera with night view, microphone, intercom
- Room at the bedside for the titration device
- Washroom close by
Monitoring station
- Outside the room, close to the door
- Live signals and video for every bed
- Intercom to each patient
Support area
- Sensor cleaning and drying
- Consumables storage
- Charging and download for home recorders
- Scoring and reporting desk
In many labs one technician watches more than one bed from a shared station, so put the beds next to each other and the station between them. If you are converting an existing ward room, we can look at the space with you during planning.
Sleep lab equipment list
What you buy follows from the studies you chose. As an authorised Löwenstein Medical dealer we supply the Sonata PSG, Scala and SAMOA polygraphs and the prismaLAB titration device, and we install, calibrate and train on each of them.
In the patient room
- PSG recorder and sensor set for each bed (Sonata)
- Camera with night view, and a microphone for synchronised video and audio
- Lab CPAP / BiLevel device at the bedside for titration nights (prismaLAB)
- Oxygen supply if your titration protocol calls for it (oxygen for sleep labs)
- Intercom to the monitoring station
At the monitoring station
- Acquisition computer running the PSG software, with live video
- Review and scoring workstation for the technician and physician
- Secure storage and backup for recordings and reports
Full specifications are on our sleep study equipment page and in the sleep diagnostics range.
Who you need to run it
Equipment is the easy part to buy. The quality of a sleep lab comes from the people who hook up, watch and score, and from a physician who reads the raw data rather than only the summary page.
Sleep technicians
They prepare the patient, apply the electrodes and sensors, run the calibration checks, watch the signals and video through the night, note what they see, and start CPAP on a titration night. Many labs also train them to score.
A sleep physician to report
A pulmonologist, neurologist, ENT surgeon or other physician with sleep medicine training reviews the scored study, signs the report and decides therapy. In a smaller centre this is often a visiting consultant.
A coordinator
Books studies, sends preparation instructions, and, if you run home testing, tracks which recorder is with which patient and when it comes back.
Biomedical support
Someone in-house who looks after sensors, cables and computers day to day, and calls us when something needs the supplier.
Training from us: when we install a system, our team trains your technicians and clinical staff on equipment operation, patient preparation, data acquisition and basic scoring. Refresher sessions and remote support are available after you go live.
Scoring to AASM, and what goes in the report
Most sleep labs score to the AASM Manual for the Scoring of Sleep and Associated Events. It sets where electrodes go, how signals are filtered and sampled, and how sleep stages, arousals, apneas, hypopneas and limb movements are scored. Sonata is built to that manual for setup, digitisation and scoring, which keeps your reports comparable with other labs.
Sleep is staged in 30-second epochs. Automatic analysis gives a first pass, but a technician should go through the study and a physician should review it before signing. The manual allows hypopneas to be scored with a 3% desaturation or arousal rule, or with a 4% desaturation rule. Agree which one your lab uses, state it on every report, and stick to it, because the choice changes the AHI.
Home polygraphy has no EEG, so it cannot see sleep or arousals. The index is calculated over recording time, not sleep time, and can under-call milder disease. A negative home test in a patient with strong symptoms is a reason to do a full PSG, not to close the file.
A PSG report usually includes
- Sleep architecture: time in each stage, sleep efficiency
- Apnea-hypopnea index (AHI), split by position and stage
- Oxygen desaturation index and lowest SpO₂
- Arousals and periodic limb movements
- ECG observations
- Technician notes and the hypopnea rule used
- The physician’s interpretation and recommended therapy
A sleep centre in a hospital: where the patients come from
A sleep lab inside a hospital rarely lacks patients. What it lacks is a route for them to reach it. Snoring, daytime sleepiness and witnessed pauses in breathing turn up in many OPDs, and most of those patients are never asked about sleep. A short questionnaire at triage, such as the Epworth Sleepiness Scale or STOP-BANG, and a simple referral form do more for a new lab than advertising.
Departments that commonly refer
- Pulmonology
- ENT
- Cardiology: resistant hypertension, atrial fibrillation
- Neurology
- Diabetology and endocrinology
- Bariatric surgery
- Anaesthesia pre-operative clinics
- General medicine OPD
The patient’s path through your lab
- Screening in OPD
- Choice of study level
- Sleep study
- Scoring and report
- Therapy decision
- Titration and CPAP / BiPAP
- Follow-up
Send the report back to the referring doctor as well as the patient. Referrers who see results keep referring.
Home sleep testing as a second line
Even a busy lab has only so many beds a night. Home testing with a polygraph takes the straightforward cases off the lab list: uncomplicated adults with a high likelihood of moderate to severe obstructive sleep apnea, which is where AASM guidance places it. The lab then keeps its nights for the patients who need EEG, titration or a technician watching.
Patients with significant heart or lung disease, suspected central apnea, neuromuscular weakness or a suspected non-breathing sleep disorder should go straight to the lab.
The device
SAMOA for compact breathing-only testing; Scala when you want extra electrode inputs or online recording.
The fitting
A technician fits it at the patient’s home in the evening, or teaches the patient at the clinic.
The return
The recorder comes back the next morning, is downloaded, scored and reported like any other study.
The safety net
Inconclusive or negative with strong symptoms? Book a full PSG.
After the diagnosis: CPAP and BiPAP follow-up
A sleep lab that diagnoses apnea and then lets the patient find a CPAP machine alone loses most of the value of the test. Plan the therapy side before you open.
Titration
On a titration night the technician raises the pressure until the events stop, with the PSG recording throughout. Some labs run split nights, diagnosing in the first half and titrating in the second. prismaLAB offers CPAP, APAP and BiLevel modes and connects to the PSG.
The home device
We supply Löwenstein Prisma Smart auto CPAP and Prisma 25ST / 30ST BiPAP machines on sale or monthly rental, with mask fitting, so your patients leave with a working setup. CPAP machines · BiPAP machines · CPAP rental
Follow-up
The first weeks on CPAP decide whether a patient stays on it. Book a review, read the therapy data the machine records, and fix mask leaks and pressure complaints early. A follow-up clinic run by the lab also brings patients back for the next study they may need.
Starting a sleep study business outside a hospital
Diagnostic centres and independent clinics can run a sleep study service too. The pieces are the same, arranged differently. Home testing keeps the fixed cost low, because you need recorders and people rather than a lab room. You still need a physician with sleep medicine training to report, and you need doctors who will send you patients, so build those relationships before you buy equipment.
Check the registration and licensing your state requires for a diagnostic centre with the local authorities before you start. We can advise on equipment and workflow, not on licensing.
Before you call any supplier
Have an answer, even a rough one, to each of these.
- Which study levels you will offer in the first year, and which later
- Which room will be the sleep room, and where the monitoring station will sit
- Who will do the overnight hook-up and monitoring, and who will score
- Which physician will review and sign reports
- Which departments will refer patients, and how the request reaches you
- Whether you will offer home testing, and who handles device pick-up and return
- How patients diagnosed with apnea will get CPAP or BiPAP and be followed up
Setting up your sleep lab with Srivari Healthcare
Our turnkey sleep lab setup service takes a hospital from the first conversation to the first patient: we look at your requirements, help plan the room, select the equipment, install and configure it, train your team, and stay on for support after go-live. We also help you understand NABL documentation and quality processes if you plan to apply. For what the equipment side costs, see what decides a PSG machine price. The same Sonata and Scala systems are used for the Level 1, 2 and 3 studies we arrange for patients through our sleep lab service in Chennai.
- Requirement analysis
- Planning and design
- Equipment selection
- Installation and configuration
- Training
- Go live and support
Starting a sleep lab: common questions
Related pages
Planning a sleep lab? Talk it through with us
Tell us about your hospital or clinic and the studies you have in mind. Our team will call to go through the plan, suggest the equipment for it, and send a written quotation.
Sleep lab setup enquiry
Tell us about your facility. Our sleep lab team will call you with a recommendation, demo and quotation.