November 30, 2024 • 36 mins
My guest today is Dmitry Spektor, RPSGT, CCSH. Dmitry is a registered sleep technologist with over 20 years of experience in all aspects of sleep disorder medicine, sleep research, and clinical trials.
He is the Sleep Lab Operations Manager for Pediatric Sleep Specialists in Texas (offices available in Texas and Colorado). Previously, he was the Lead Sleep Technologist for Memorial Hermann Hospital and Children's Hospital Los Angeles.
You can learn more about Dmitry via his LinkedIn profile here.
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Episode Transcript
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(00:00):
Hi everyone, and welcome back to Airway First, the podcast from the Children's Airway First
(00:27):
Foundation. I'm your host, Rebecca St. James. Today we'll be jumping into part two of our
sleep study series with today's guest, Dimitri Spector. Dimitri is the sleep lab operations
manager at Memorial Hermann Health in Houston, Texas. And in today's episode, he's going to
give us a behind the scenes tour of the facility and give us a quick introduction to the various
(00:53):
machines and cables and anything else that would be used during a traditional sleep testing event.
The goal of this episode is to allow you to become familiar with what a traditional or the average
sleep facility looks like, what the equipment is like, just so it can kind of take away some of
the scary unknown that goes along with it will allow you and your child to be more comfortable
(01:18):
when you go in for your child's sleep test. So let's jump into today's episode with Dimitri
Spector. Perfect. Thank you so much for joining us in part two of our series, Dimitri. Appreciate
you being here. Thank you for having me. It's my pleasure. Absolutely. Absolutely. So I know we're
going to do a lot today. And this series is building on what we did with JT in our first part of the
(01:40):
series where he outlined what the sleep report looks like and really kind of what, from a high
level, to expected a sleep study. In part two, you're going to pick up the ball and run with us
today. And we're going to really prepare parents a little bit better for the experience. And then
you're also going to give us a tour of the sleep center. I will absolutely do that. So exciting.
(02:05):
So before we get going, would you mind just telling parents a little bit about you and what you do?
Sure. Absolutely. I'm my name is Dimitri Spector. I have been in the field of sleep medicine for
26 years now. I'm currently the sleep lab operations manager for pediatric sleep specialists in Texas.
(02:26):
And we also have offices in Colorado with three locations in Denver, in Colorado Springs,
and in Lublin. And you can get more information on the company at pediatricsleepspecialists.com.
And my previous experience includes working for Memorial Herman here in Houston at the Memorial
(02:46):
City location. I was the lead sleep technologist there for both the pediatric and adult sleep lab.
And other previous pediatric experience, I worked at Children's Hospital Los Angeles as well.
Wow. But that one was busy. It was very busy. It's very busy. It's one of the top cystic fibrosis
(03:06):
centers in the world, actually. So we sell patients from all over the world. Wow. That's cool.
That is cool. Okay. So we were talking offline and let's go ahead and set the expectation because
I was a little surprised by this. And in our world, because of the amazing Kevin Boyd,
in our world, nine years old and up, our geriatric is kind of how we term them. And we really focus
(03:31):
on zero to two is really where you want to grab them that first thousand days. But
fixed by six, so six is kind of not that it's too late, but we want to handle it before them.
But when it comes to how we approach children in a sleep center, it's not a cutoff, but your line of
how you work with them is a little different. Correct? As far as billing is one thing, but
(03:53):
then eventually how they work is different. Correct. So as far as billing is concerned,
the children six years and up are billed as adult sleep studies. That still blows my mind.
Yeah. But that being said, really developmentally, from my experience, that change really happens
around four or five at a time where you can really talk to your kids and really explain
(04:15):
things and where they can understand what's happening. I feel it's around four or five. So
what I'm going to focus on today is really kids younger than that. And as well as kids with
developmental delays, any kind of sensory issues and autism spectrum disorders, that kind of alters
(04:35):
the age range a little bit because you're going to run into some issues that are not age related.
Okay. And that totally makes sense. So let's go ahead and just dive in before we take the tour.
Let's talk about what parents can do, maybe some of the dos and don'ts, and how they can prepare
their child for an evening at sleep center. Absolutely. So ideally to really ensure a great
(05:00):
sleep study and the good experience for your child, you want to start preparing really almost as
soon as you make the appointment. So a couple of weeks out, a month out, start mentioning that
you're going to go on a trip or you're going to spend some time away from the house. You're going to
go, you can say doctor's type office, but really start talking about it. There's a million pictures
(05:24):
on Google that you can find that you just Google pediatric sleep study. I would suggest finding the
pictures where the kids are laughing, they're smiling, maybe pictures with parents. That'll kind
of give an idea of what to expect as far as what sensors are put on and how involved it is because
it's really involved study. There's a lot of wires. There's a lot of sensors. Yeah. The one thing to
(05:48):
stress is it's a completely painless procedure. Kids that don't like shots, there's no shots,
there's no needles involved. So it's a completely painless procedure. So just to show a little bit,
most sensors look like this one here and it's a little cup. Oh, it's so tiny. With a long wire
(06:09):
and one end will get plugged into a patient interface box and one end will go on the patient.
And these have a little conductive paste in them and they're taped onto the skin. And they feel
nothing. There's no currents or anything that they feel they'll just have it stuck on. Absolutely not.
Absolutely not. So our bodies produce electrical impulses when muscles fire,
(06:32):
brainwaves are all electrical impulse with them. Ultimately, that's what we're looking at when we
run a sleep study. The other thing you can do is you can ask your sleep lab for some samples.
For example, we are more than happy to give out a couple wires and the biggest issue we
normally have is this sensor right here. Oh, yeah. It's like an oxygen cannula. However,
(06:58):
there's nothing flowing through this. OK. This is what we used to monitor breathing and carbon
dioxide levels. And this does go in the nose. So I could see why that one they would not like.
Like I said, you can get samples, ask the sleep lab if they can give you something to practice with.
The more you can expose your child to what is to come, the better the outcome will be.
(07:23):
And if for some reason the sleep lab is not willing to give you at least the cannula that goes into
the nose to practice with, they're very cheap on Amazon. OK. You can find one on Amazon and you
don't have to worry about whether there's something hanging down over the mouth. Ultimately, the
biggest problem is the part that goes into the nose. I mean, I'm an adult and I wouldn't be excited
(07:46):
about that. So I can't just imagine. But it is a little bit easier to explain to you why we're
doing these things. Right. So ultimately, it's exposure. The more you desensitize the child to
what's to come, the more comfortable they will be. He can also ask to take a tour of the sleep lab
prior to your bed. OK. That can be very helpful, especially for children who are apprehensive
(08:10):
about going to the doctor. That is extremely helpful. The other thing you can do is practice
putting on band-aids, treating cuts and scrapes. If your child usually doesn't like band-aids put on,
they're probably not going to be happy with sensors that we put on during the sleep study
because ultimately a ton of band-aids. So you can practice with that. So again, it all starts
(08:36):
preparation before the sleep study. Now, for kids who are really young, like zero to one,
but you're not really going to do a whole lot of preparation because there's not a whole lot you
can explain. But once you're in, you know, your child starts becoming verbal and they can understand
certain things, you can start explaining as much as possible. Find that. But usually it's great
(09:00):
with my own son. We do that all the time before we go to the doctor. Any kind of new specialist,
whether it's a dentist or an eye doctor, we're always talking about it. There's a ton of tools
and forms of educational cartoons you can watch also. So going to the doctor. Absolutely. One
of my favorites is Daniel Tiger. Daniel Tiger. And they have multiple scenarios from potty training
(09:27):
to going to the doctor and other things you can find. But ultimately, it's whatever you're
comfortable with and how you want to talk about it. Now, when it gets closer to sleep study time,
for example, about a week before, you want to try and have as consistent of a sleep schedule as
possible. Now, you really want to do that always, but especially preparing for a night away from home
(09:50):
at a sleep center. You want to ensure that there is some sleep for us to record.
Right. Okay. Ultimately, it sleeps then. So a consistent sleep break schedule really helps
out a lot. One big misconception that I've seen and is some parents will skip a nap. For kids who
(10:12):
are still napping, they will skip a nap in preparation for a sleep study so that the kid is more tired.
That is a big don't. Overtired children will stay up and they will not be happy through the set of
these sets. Ultimately, you don't want to alter your routine as much as will stay consistent.
(10:34):
Now, on the day of the sleep study also, you want to make sure a child is bathed before you come in.
And without any lotions and any hair products, that will make things very difficult to because
as far as digging through the gel in the hair or trying to get a tape to stick to lotion, virtually
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possible. The other thing is, parents who have had sleep studies and who have been diagnosed with
sleep apnea, and if you're using a CPAP machine, make sure to bring that to your sleep study with
your child. You don't want to be snoring all night next to your kid. That makes sense. Big thing I want
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to mention is sleep labs did not disperse any medication. So any kind of medication that your
child needs to take, you should bring with you. And doubly important for kids with asthma or kids
with seizures, you really want to make sure you bring the rescue medications to the sleep lab.
(11:37):
As far as what to bring, what else to bring with and how to address your child, the easiest thing
for a technician to work with is a two-piece pajama that is loose fit. Pants are better than
shorts because pants help hide the wires a little bit. So it helps us keep everything contained.
Tights, gallons are a little bit harder to work with. So the best thing is just
(12:01):
a regular old two-piece pajama for the top and the bottom. What about things like a pillow or
a certain stuffed animal or something like that? I'm glad you mentioned that. We encourage to bring
as much as possible and whatever will make your child more comfortable, bring it with. As long as
it's not alive, we can bring it with you. Pillows, favorite blanket, a little comfort object, whether
(12:30):
it's a blankie or a stuffed animal, anything like that is absolutely fine. If your child has an iPad
or anything like that to distract them during the procedure, the setup procedure, you can absolutely
bring that. Sublabs will have TVs in them. We don't because we like to encourage good sleep hygiene.
(12:52):
So we do not have TVs. But if a screen is what it takes to distract them and to get them there
through the hookup, that's okay. And usually what time ish do they arrive? So we run sleep studies
from about our first arrivals at seven. We generally stagger patients about half an hour apart.
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So arrivals anywhere between seven and seven thirty and wake up time in the morning is between
six and six thirty in the morning. And the reason we ended that early is because the technician is
at that point working about a 12-hour shift plus. Yeah, they're gonna be tired. Yeah. So there's only
so much that we can push a person to do. And I think we learned in JT's that there's only a certain
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number of patients per technician as well, right? Because technicians have to monitor
constantly. Absolutely. So children who are a little bit more complex, we will run those that
a one to one ratio. So autism spectrum disorder, neuromuscular disease, seizures, anything that
requires undivided attention from the technician, we will schedule those that a one to one ratio.
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The more general sleep studies, they generally run at a two to one ratio, but never more than two
patients to what technician. Which makes sense. Yeah, based on just what he showed us, that would be
two to one which stress me out. But I can see how you could possibly do it if you understood it and
you had enough experience. But I can see that. And then there are individual rooms, right? This
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isn't like one big giant barn. Everybody gets a cot. I mean, it's no no. Parents can sleep with
them in their own little kind of habitat, right? Correct. So we have the way we have it set up.
And again, I'll walk through the lab and I'll show everything. Our setup is we have separate
bedrooms. There is a patient bed and the bed for parents in the room. We have bathrooms in each
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one of our rooms. Now that is not necessarily standard. It is quite common to have a shared
bathroom for for all the rooms in a sleep lab. But it's it's generally very close fight to the
bedroom itself. I would think with tiny people that that's really handy because, you know,
some of them are a little hesitant of other people. So that would help keep the experience
(15:10):
calmer. It's also the American Academy of Sleep Medicine standard that all rooms have a bathroom
within 75 feet of them. Okay. And most are much, much closer to that. 75 feet can see.
It's a long way. Yeah. Most sleep labs have either bathrooms directly inside the room
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or very close by. Now, some will have showers. Some won't. We do have showers in our lab here
in Houston, but some labs will not have showers. So be aware of that. I find that most prefer to go
home and shower out at any way afterwards. Yeah. Just bring your tiny people prepped and ready.
(15:53):
Right. Right. But things like snacks. And granted, mine are older. I'm thinking back.
There was always a snack and a water right before bed. Can they bring those kind of things?
So, yeah, you can bring anything you like. You can whatever they normally do on a regular basis.
So our goal for the initial sleep study is to see the most typical night sleep that we can.
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Okay. So whatever it takes to get in there. Absolutely. Absolutely. So the goal is to
establish a baseline. So we don't generally address like even if a technician sees some
bad habits before you're going to bed, we won't address that. We'll make a note and then
referring provider or whoever the patient is scheduled to follow up with, they will see that's
(16:40):
what was happening and they will address those issues at that point. But the goal of the initial
sleep study is to get that baseline to establish what's happening during the night. How long is
it taking to fall asleep? How often are they waking up? What is waking them up? What is happening
before they get into bed? And all rooms have video cameras in them and they are recording.
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And we start that recording from the moment that you walk into the sleep room. So that way we can
kind of assess the bedtime routine that happens a little bit as well. And that makes sense. That
makes sense. And then so how does this, before we go into the sleep center, the labs itself,
how did your approach, this checking them in, setting them up, differ from one child to a child
(17:30):
that's perhaps on the spectrum? So it's really a very, I want to say kind of informal atmosphere.
And I'll show you generally, there's some decorations on the wall is a bit of a kid friendly.
It does not blatantly look like a doctor's office. And the technician greets the child
at the door. It was ultimately up to the technician to establish that record. Now again,
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I highly encourage a sleep lab visit prior to the sleep study. If you anticipate that your child
will be anxious about the procedure and about new places in general, come in during the daytime,
have a walk through. I don't know any sleep labs that would or she was that. And if they do, you
should probably look elsewhere for a child's sleep study. That always puts them at ease. Yeah.
(18:19):
Oh, I mean, the unknown is scary, right? Especially when you're tiny, but for all of us,
it can be scary. Absolutely. And the parent, if you want to bring something to the lab beforehand,
so that your child finds it there, that can be helpful as well. So really anything that you
want to do to make your child more comfortable, everything is fair game. We ultimately want
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to do our best to try and get the best recording we have and have it be as the least amount of stress
for your child as possible.
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You're listening to Airway First with today's guest, Dimitri Specter. You can find out more
about the Children's Airway First Foundation and our mission to fix before six on our website at
childrensairwayfirst.org. The CAF website offers tons of great resources for both parents and
medical professionals. In our parents portal and clinicians corner areas, you can find educational
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and informational content, including videos, blogs, our recommended reading lists, comprehensive
medical research, podcasts, events, parent support, and several educational opportunities.
Parents are also encouraged to join the Airway Huddle, our Facebook support group,
which was created for parents of children with airway and sleep-related issues.
(19:59):
You can access the Airway Huddle support group at facebook.com. Backslash Groups. Backslash Airway
Huddle. Are you a medical professional or parent that is interested in being a guest on the show?
Then shoot us a note via our contact page on our website, or send us an email directly at
infoatchildrensairwayfirst.org. As a reminder, this podcast and the opinions expressed here
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are not a medical diagnosis. If you suspect your child might have an airway issue,
contact your pediatric airway dentist or pediatrician. And now, let's jump back into
my interview with today's guest, Dmitri Speckman.
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And I know this is only going to be to a tiny group of our listeners, but I'm really
stretching trying to think of scenarios. But you have two tiniest, let's say they're two,
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and they're twins. And they're used to being two-get-there, but only one's getting the sleep
study. Could the parent bring the other one if it helps calm them down? Or is that okay?
That could disrupt it. We got to figure something else out. Have you had things like that?
Absolutely. So those are case-by-case basis approach. We don't rule anything out. Generally,
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the setup is one parent stays with one child. Now, if more than one child in a family is having a
sleep study done, two parents will need to come and stay. So you need to have one child and one
parent per room. Now, if the child is used to a sibling being in the room with them, you can
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certainly ask the lab if that would be acceptable. And patient acceptance policies will vary slightly
from lab to lab. For example, we require a parent to stay with anybody under 18. Some labs may require
a parent to stay with somebody with anybody under 21. And that strictly facility-based policy.
(22:18):
Certainly under 18, a parent will always be required to stay unless it's an inpatient study
and the patient is checked in at the hospital. Okay. Oh, wow. I didn't even think about that.
So that's true. They could just wheel them down. But there are cases for that.
Absolutely. So there's two differences in sleep labs. There's something we have here,
(22:40):
which is a freestanding independent sleep lab. But then there's also hospital-based sleep labs.
Now, even hospital-based sleep labs, a routine sleep study will be an outpatient procedure.
So it's not going to vary much from an independent sleep lab, a freestanding one.
They also cannot administer any medication, even though they're in the hospital.
(23:03):
So in the hospital, it does not sleep well. Okay. Now, another thing that is sometimes done is
patients who are inpatients at the hospital will have sleep studies done bedside on the floor.
At that point, they're checked into the hospital and the parent does not always at bedside,
which is okay. Okay. Got it. Well, I think we have some good... So we're actually a really great,
(23:27):
great, great do's and don'ts for parents. They know what to pack. They know how to prep the child.
If you're ready, let's go into the sleep lab. Let's go. This is our front door. And I'm just
going to walk in as if I'm coming in for a sleep study. We have a reception area here.
So you generally will not spend much time in a reception area. In most sleep labs,
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the technician will greet you at the door and show you back to your room right away.
Okay. If several patients arrive at the same time, may need to wait in the waiting area for
just a few minutes. This is not a place where you will spend much time.
So again, not like a doctor's office. No, there's no waiting. That'll help kids. Yep.
(24:11):
Correct. If there's one technician on duty, you will only be one of two appointments. If there's...
We have four bedrooms here. So if we're running more than two patients, we'll have two technicians
on duty. Okay. And then as we walk through, this is a pretty typical setup where this is the
technician's control room. And this is where we monitor from. Okay. And it is... It usually is
(24:36):
in close proximity to the reception area. And the patient rooms, there's our little
jungle animals here on this wall. And patient rooms are generally very short distance from the
control room just so that we can get to the patient quickly if needed. Okay.
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This is the way our room is set up. So again, we have a restroom right in the room with a shower.
We have our patient bed. And we do have safety rails for the younger children.
And we have a cot for the parent to sleep on. I like how close it is though. That's got to be
comforting to the child. Absolutely. It's going to be across the room. That's awesome. So most rooms
(25:21):
are fairly cozy with not a whole lot of room to spread out. This is actually a pretty standard
sized room for a sleep study. But yeah, the parent is right next to the child. Now we can... We do
have cribs as well. We can roll a crib in if for the younger kids who are still in cribs, we will
generally swap out the cot for a crib and then the parent can sleep in the bigger bed. Okay.
(25:46):
Now next to the bed, generally you will have some equipment. Okay. And this is the recording
equipment. So we have our recording equipment here. All the sensors plug into a box that looks
similar to this. We use the Phillips Alice diagnostic system. But ultimately the setup
(26:07):
is very similar with whatever system to use. And then there's a CPAP machine
usually as well. And that is for treatment of sleep apnea. Okay. Now we have also an exam table
in this bedroom. And this is so that we can see patients during the daytime and clinic.
(26:28):
Okay. Now some sleep labs will have these. Some sleep labs will have
mercy beds that convert to exam tables. So there will be slight variations. But this kind of gives
you a general idea of the setup of the room. Now I did mention that there's a camera which
will record all night long. It does record video and audio. Oh, okay. Okay. So the technician can
(26:54):
generally hear you. We'll hear you all night long. So you can, if there's anything you need during
the night, you can always call the technician and they will come in and help you out. Okay. And
there's also intercom systems to where the technician can talk to you as well. And that is
basically it for the tour. It's very simple. It is very simple. But I mean, you could tell,
(27:17):
especially if the lights were dimmer, I could see how, okay, it's not quite as scary as a doctor's
office. No, and getting to be right there. I'm sure that's got to be very reassuring.
Absolutely. And we are able to dim the lights. We do have a dimmer switch to where if somebody's
light sensitive, we can turn it down and work in a little darker environment.
Yeah. That's what I think, especially for kids on the spectrum or something like that.
(27:42):
Light sensitivity. Do you come in, you get checked in, and then how long does it take
typically to wire up a child? So it will depend on the child. Of course. For somebody who's
cooperative, it can take anywhere from half an hour, 45 minutes. For somebody who's a little
(28:03):
less cooperative, it can go to an hour plus. Just also super curious kids that ask a lot of questions.
Well, it will take a little bit longer. Because the last thing I want to do is rush a child during
the setup. If they're asking questions and they're involved, that's always a good thing.
They're always going to do much better if they're involved. And personally, if I'm running a sleep
(28:26):
study, I try to get the kids as involved as possible in what I'm doing. Whether it's helping me put
the little stickers on them, the sensors to plugging them into the box, to letting them put,
especially the cannula, I always like to let them try and put it on themselves. It'll tickle their
(28:47):
nose a little bit, but they're in control at that point. So for kids, control is a huge thing.
Yeah. So the more control you can or more perception of control that you can give the
child the better the outcomes are. I agree with that. That's kind of the goal of life, right?
That's parenting. Absolutely. And then so if you would walk us through the morning, so
(29:08):
6, 6, 30, you go in, we wake him up. Okay. So in the morning, the technician will determine
the best type two and the study. So usually it's not set in stone. So it'll depend on how well
the child is slept through the night, how well they're sleeping towards the end of the night.
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If it's 5, 5, 30, and I see that the child is really struggling, they're not sleeping,
they keep waking up. And if we have enough data, I will go in and I will say, hey,
they've been awake for a while, we have enough data, why don't you go home and get some rest.
Now, if there was a really long wake period in the middle of the night,
(29:54):
and then they're sleeping well towards the morning, we will try to let it run as long as possible,
just so that we can get the most data that we can from the sleep studies. So again,
6 to 6, 30 is really just a rough estimate. I have run studies to 7, 7, 30 before,
and I've ended studies at 4, 35 o'clock before as well. It can fluctuate a little bit. But general
(30:19):
rule of thumb is about 7, 7, 30 check in, sometimes even a little earlier, sometimes even 6, 30.
That's just so that you can get to the lab and so that we try to keep things as not rushed as possible.
Right. When you come in here, I want to let you settle into your room. I want to let you get
(30:40):
comfortable. I want to let the kid explore a little bit, climb all over the bed, get comfortable,
wash face, brush teeth, or whatever you do to get ready for nighttime. Get all of that out of the
way and just get comfortable and start to wind down. Which makes sense. And that's why earlier
arrival time. Now, there's some paperwork to fill out. You may be asked to come in a little bit
(31:03):
earlier. The way we do it is we like to do most things through the patient portal. So we send
everything out beforehand. And even if the paperwork's not filled in prior to the visit,
it's very easy for the parent to access the portal once they come in from a phone or from a tablet,
whatever it may be. If there's physical paperwork to fill out and it's given when you arrive at the
(31:27):
lab, you may be asked to come in a little bit earlier. I have to say, I think I'm spoiled
because of my Astrame in hospitals and doctor's offices so often. Anytime I have to go somewhere
new and they hand me paper, I just kind of like, I don't know what to do with this. Do you have a
portal? Do you have something I can type on? Because it's just so much easier. Absolutely.
It's not going to lie. It's just so much easier. I think we're all going the route of embracing
(31:52):
technology as much as possible. It's even AI involved in sleep study analysis now.
Oh, wow. Oh, that's wild. I can't wait to do a follow-up on that.
Absolutely. JT is a great person to talk to about that. He knows.
Oh, yeah. He's got his finger on the pulse. He's always at the forefront of technology.
(32:13):
He is. And for those who are in the area, it's actually JT's podcast comes out next week.
And it will be too late for you. But there is a conference next week and JT will be at that
speaking. Correct. Yes. He's speaking at the Texas Society of Sleep Professional annual meeting.
I unfortunately cannot attend that one. But I'm hoping that his talk will be recorded so I can
(32:37):
catch it afterwards. Yeah, I've heard him speak. It's great. He's such a good speaker. And obviously,
everybody listening to this now knows as well because they got introduced to him in episode one
of this series at the end of every episode. Usually, I hand it back to you, our guests,
because you are the experts and let you leave with final words. Do you have some final words that you
(32:58):
could leave with our parents? Prepare, prepare, prepare. That's all I can say.
I figured that's what it would be. Yeah. Yes. You cannot prepare too much. It's as,
it can be a very simple procedure, but it can also be a very tough one because there's about
20 of these plus that go on as well as a couple belts. There's a pulse oximeter to look at pulse
(33:24):
and oxygen levels on the finger for the younger kids will put it on the toe. So when we say wired
up from head to toe, we literally mean you made it. Yeah. So the more you can expose your children to
really have it be familiar to them, the less anxiety, less apprehension they'll have when
(33:47):
they come in. And especially the kids that are old enough to understand. Show them pictures,
get some wire samples and just start gradually introducing it a month before, a couple weeks
before, a week before, a couple days before remind them that, hey, you remember we're going to go on
this trip. We're going to spend the night out, make it fun for them, make it like vacation.
(34:12):
Yeah. Oh, I like that. And it's funny. I was just had it popped in my head too.
I'm sure other parents have done this, but you talked about put band-aids on them, right? So
they're used to having that. If you've got some yarn, why not have a little yarn stick out so they
can get used to something like the wire dangling. That is amazing. That's got to be uncomfortable,
especially for a child with sensory. That's got to be a hard thing to get used to.
(34:34):
Absolutely. Absolutely. Kids that have trouble when you touch their head, the more you can
prepare that, the better, because the majority of the sensors do go on the head and on the face.
Oh, that's good to know. Okay. Well, there you go. Now you know where to put the band-aids.
Absolutely. Yes. Yes.
Thank you so much for answering these questions, giving us great info and for the tour.
(34:55):
For so many of us, we've never seen the inside, so it's really, really
helpful as a parent to know what you're walking into.
My pleasure. Thank you so much for having me. And I hope that this really relieves some stress for
parents preparing for a sleep study. And hopefully what I said resonates. And it'll make it easier
for the technicians who will be running the studies as well.
(35:17):
My thanks, though. Yep. Thank you. Thank you, Rebecca.
Thanks again to today's guest, Dimitri Spector, for the amazing behind-the-scenes tour of the Sleep
Lab and to each of you for listening to today's episode. You can stay connected with Children's
Airway First Foundation by following us on Instagram, Facebook, X, LinkedIn, and YouTube.
(35:40):
Don't forget to subscribe to the Airway First podcast from your favorite podcasting platform,
so you won't miss an upcoming episode. If you'd like to be a guest or have an idea for an upcoming
show, shoot us a note via the contact page on our website, or send us an email directly at
info at childrensairwayfirst.org. Today's episode was written and directed by Rebecca St. James,
(36:02):
video editing and promotion by Ryan Drone, and guest outreach by Kristie Bojipin.
And finally, thanks to all the parents and medical professionals out there that are working hard to
help make the lives of kids around the globe just a little bit better. Take care, stay safe,
and happy breathing, everyone.
Hi everyone, and welcome back to Airway First, the podcast from the Children's Airway First
(00:27):
Foundation. I'm your host, Rebecca St. James. Today we'll be jumping into part two of our
sleep study series with today's guest, Dimitri Spector. Dimitri is the sleep lab operations
manager at Memorial Hermann Health in Houston, Texas. And in today's episode, he's going to
give us a behind the scenes tour of the facility and give us a quick introduction to the various
(00:53):
machines and cables and anything else that would be used during a traditional sleep testing event.
The goal of this episode is to allow you to become familiar with what a traditional or the average
sleep facility looks like, what the equipment is like, just so it can kind of take away some of
the scary unknown that goes along with it will allow you and your child to be more comfortable
(01:18):
when you go in for your child's sleep test. So let's jump into today's episode with Dimitri
Spector. Perfect. Thank you so much for joining us in part two of our series, Dimitri. Appreciate
you being here. Thank you for having me. It's my pleasure. Absolutely. Absolutely. So I know we're
going to do a lot today. And this series is building on what we did with JT in our first part of the
(01:40):
series where he outlined what the sleep report looks like and really kind of what, from a high
level, to expected a sleep study. In part two, you're going to pick up the ball and run with us
today. And we're going to really prepare parents a little bit better for the experience. And then
you're also going to give us a tour of the sleep center. I will absolutely do that. So exciting.
(02:05):
So before we get going, would you mind just telling parents a little bit about you and what you do?
Sure. Absolutely. I'm my name is Dimitri Spector. I have been in the field of sleep medicine for
26 years now. I'm currently the sleep lab operations manager for pediatric sleep specialists in Texas.
(02:26):
And we also have offices in Colorado with three locations in Denver, in Colorado Springs,
and in Lublin. And you can get more information on the company at pediatricsleepspecialists.com.
And my previous experience includes working for Memorial Herman here in Houston at the Memorial
(02:46):
City location. I was the lead sleep technologist there for both the pediatric and adult sleep lab.
And other previous pediatric experience, I worked at Children's Hospital Los Angeles as well.
Wow. But that one was busy. It was very busy. It's very busy. It's one of the top cystic fibrosis
(03:06):
centers in the world, actually. So we sell patients from all over the world. Wow. That's cool.
That is cool. Okay. So we were talking offline and let's go ahead and set the expectation because
I was a little surprised by this. And in our world, because of the amazing Kevin Boyd,
in our world, nine years old and up, our geriatric is kind of how we term them. And we really focus
(03:31):
on zero to two is really where you want to grab them that first thousand days. But
fixed by six, so six is kind of not that it's too late, but we want to handle it before them.
But when it comes to how we approach children in a sleep center, it's not a cutoff, but your line of
how you work with them is a little different. Correct? As far as billing is one thing, but
(03:53):
then eventually how they work is different. Correct. So as far as billing is concerned,
the children six years and up are billed as adult sleep studies. That still blows my mind.
Yeah. But that being said, really developmentally, from my experience, that change really happens
around four or five at a time where you can really talk to your kids and really explain
(04:15):
things and where they can understand what's happening. I feel it's around four or five. So
what I'm going to focus on today is really kids younger than that. And as well as kids with
developmental delays, any kind of sensory issues and autism spectrum disorders, that kind of alters
(04:35):
the age range a little bit because you're going to run into some issues that are not age related.
Okay. And that totally makes sense. So let's go ahead and just dive in before we take the tour.
Let's talk about what parents can do, maybe some of the dos and don'ts, and how they can prepare
their child for an evening at sleep center. Absolutely. So ideally to really ensure a great
(05:00):
sleep study and the good experience for your child, you want to start preparing really almost as
soon as you make the appointment. So a couple of weeks out, a month out, start mentioning that
you're going to go on a trip or you're going to spend some time away from the house. You're going to
go, you can say doctor's type office, but really start talking about it. There's a million pictures
(05:24):
on Google that you can find that you just Google pediatric sleep study. I would suggest finding the
pictures where the kids are laughing, they're smiling, maybe pictures with parents. That'll kind
of give an idea of what to expect as far as what sensors are put on and how involved it is because
it's really involved study. There's a lot of wires. There's a lot of sensors. Yeah. The one thing to
(05:48):
stress is it's a completely painless procedure. Kids that don't like shots, there's no shots,
there's no needles involved. So it's a completely painless procedure. So just to show a little bit,
most sensors look like this one here and it's a little cup. Oh, it's so tiny. With a long wire
(06:09):
and one end will get plugged into a patient interface box and one end will go on the patient.
And these have a little conductive paste in them and they're taped onto the skin. And they feel
nothing. There's no currents or anything that they feel they'll just have it stuck on. Absolutely not.
Absolutely not. So our bodies produce electrical impulses when muscles fire,
(06:32):
brainwaves are all electrical impulse with them. Ultimately, that's what we're looking at when we
run a sleep study. The other thing you can do is you can ask your sleep lab for some samples.
For example, we are more than happy to give out a couple wires and the biggest issue we
normally have is this sensor right here. Oh, yeah. It's like an oxygen cannula. However,
(06:58):
there's nothing flowing through this. OK. This is what we used to monitor breathing and carbon
dioxide levels. And this does go in the nose. So I could see why that one they would not like.
Like I said, you can get samples, ask the sleep lab if they can give you something to practice with.
The more you can expose your child to what is to come, the better the outcome will be.
(07:23):
And if for some reason the sleep lab is not willing to give you at least the cannula that goes into
the nose to practice with, they're very cheap on Amazon. OK. You can find one on Amazon and you
don't have to worry about whether there's something hanging down over the mouth. Ultimately, the
biggest problem is the part that goes into the nose. I mean, I'm an adult and I wouldn't be excited
(07:46):
about that. So I can't just imagine. But it is a little bit easier to explain to you why we're
doing these things. Right. So ultimately, it's exposure. The more you desensitize the child to
what's to come, the more comfortable they will be. He can also ask to take a tour of the sleep lab
prior to your bed. OK. That can be very helpful, especially for children who are apprehensive
(08:10):
about going to the doctor. That is extremely helpful. The other thing you can do is practice
putting on band-aids, treating cuts and scrapes. If your child usually doesn't like band-aids put on,
they're probably not going to be happy with sensors that we put on during the sleep study
because ultimately a ton of band-aids. So you can practice with that. So again, it all starts
(08:36):
preparation before the sleep study. Now, for kids who are really young, like zero to one,
but you're not really going to do a whole lot of preparation because there's not a whole lot you
can explain. But once you're in, you know, your child starts becoming verbal and they can understand
certain things, you can start explaining as much as possible. Find that. But usually it's great
(09:00):
with my own son. We do that all the time before we go to the doctor. Any kind of new specialist,
whether it's a dentist or an eye doctor, we're always talking about it. There's a ton of tools
and forms of educational cartoons you can watch also. So going to the doctor. Absolutely. One
of my favorites is Daniel Tiger. Daniel Tiger. And they have multiple scenarios from potty training
(09:27):
to going to the doctor and other things you can find. But ultimately, it's whatever you're
comfortable with and how you want to talk about it. Now, when it gets closer to sleep study time,
for example, about a week before, you want to try and have as consistent of a sleep schedule as
possible. Now, you really want to do that always, but especially preparing for a night away from home
(09:50):
at a sleep center. You want to ensure that there is some sleep for us to record.
Right. Okay. Ultimately, it sleeps then. So a consistent sleep break schedule really helps
out a lot. One big misconception that I've seen and is some parents will skip a nap. For kids who
(10:12):
are still napping, they will skip a nap in preparation for a sleep study so that the kid is more tired.
That is a big don't. Overtired children will stay up and they will not be happy through the set of
these sets. Ultimately, you don't want to alter your routine as much as will stay consistent.
(10:34):
Now, on the day of the sleep study also, you want to make sure a child is bathed before you come in.
And without any lotions and any hair products, that will make things very difficult to because
as far as digging through the gel in the hair or trying to get a tape to stick to lotion, virtually
(10:56):
possible. The other thing is, parents who have had sleep studies and who have been diagnosed with
sleep apnea, and if you're using a CPAP machine, make sure to bring that to your sleep study with
your child. You don't want to be snoring all night next to your kid. That makes sense. Big thing I want
(11:16):
to mention is sleep labs did not disperse any medication. So any kind of medication that your
child needs to take, you should bring with you. And doubly important for kids with asthma or kids
with seizures, you really want to make sure you bring the rescue medications to the sleep lab.
(11:37):
As far as what to bring, what else to bring with and how to address your child, the easiest thing
for a technician to work with is a two-piece pajama that is loose fit. Pants are better than
shorts because pants help hide the wires a little bit. So it helps us keep everything contained.
Tights, gallons are a little bit harder to work with. So the best thing is just
(12:01):
a regular old two-piece pajama for the top and the bottom. What about things like a pillow or
a certain stuffed animal or something like that? I'm glad you mentioned that. We encourage to bring
as much as possible and whatever will make your child more comfortable, bring it with. As long as
it's not alive, we can bring it with you. Pillows, favorite blanket, a little comfort object, whether
(12:30):
it's a blankie or a stuffed animal, anything like that is absolutely fine. If your child has an iPad
or anything like that to distract them during the procedure, the setup procedure, you can absolutely
bring that. Sublabs will have TVs in them. We don't because we like to encourage good sleep hygiene.
(12:52):
So we do not have TVs. But if a screen is what it takes to distract them and to get them there
through the hookup, that's okay. And usually what time ish do they arrive? So we run sleep studies
from about our first arrivals at seven. We generally stagger patients about half an hour apart.
(13:14):
So arrivals anywhere between seven and seven thirty and wake up time in the morning is between
six and six thirty in the morning. And the reason we ended that early is because the technician is
at that point working about a 12-hour shift plus. Yeah, they're gonna be tired. Yeah. So there's only
so much that we can push a person to do. And I think we learned in JT's that there's only a certain
(13:38):
number of patients per technician as well, right? Because technicians have to monitor
constantly. Absolutely. So children who are a little bit more complex, we will run those that
a one to one ratio. So autism spectrum disorder, neuromuscular disease, seizures, anything that
requires undivided attention from the technician, we will schedule those that a one to one ratio.
(14:04):
The more general sleep studies, they generally run at a two to one ratio, but never more than two
patients to what technician. Which makes sense. Yeah, based on just what he showed us, that would be
two to one which stress me out. But I can see how you could possibly do it if you understood it and
you had enough experience. But I can see that. And then there are individual rooms, right? This
(14:25):
isn't like one big giant barn. Everybody gets a cot. I mean, it's no no. Parents can sleep with
them in their own little kind of habitat, right? Correct. So we have the way we have it set up.
And again, I'll walk through the lab and I'll show everything. Our setup is we have separate
bedrooms. There is a patient bed and the bed for parents in the room. We have bathrooms in each
(14:49):
one of our rooms. Now that is not necessarily standard. It is quite common to have a shared
bathroom for for all the rooms in a sleep lab. But it's it's generally very close fight to the
bedroom itself. I would think with tiny people that that's really handy because, you know,
some of them are a little hesitant of other people. So that would help keep the experience
(15:10):
calmer. It's also the American Academy of Sleep Medicine standard that all rooms have a bathroom
within 75 feet of them. Okay. And most are much, much closer to that. 75 feet can see.
It's a long way. Yeah. Most sleep labs have either bathrooms directly inside the room
(15:32):
or very close by. Now, some will have showers. Some won't. We do have showers in our lab here
in Houston, but some labs will not have showers. So be aware of that. I find that most prefer to go
home and shower out at any way afterwards. Yeah. Just bring your tiny people prepped and ready.
(15:53):
Right. Right. But things like snacks. And granted, mine are older. I'm thinking back.
There was always a snack and a water right before bed. Can they bring those kind of things?
So, yeah, you can bring anything you like. You can whatever they normally do on a regular basis.
So our goal for the initial sleep study is to see the most typical night sleep that we can.
(16:15):
Okay. So whatever it takes to get in there. Absolutely. Absolutely. So the goal is to
establish a baseline. So we don't generally address like even if a technician sees some
bad habits before you're going to bed, we won't address that. We'll make a note and then
referring provider or whoever the patient is scheduled to follow up with, they will see that's
(16:40):
what was happening and they will address those issues at that point. But the goal of the initial
sleep study is to get that baseline to establish what's happening during the night. How long is
it taking to fall asleep? How often are they waking up? What is waking them up? What is happening
before they get into bed? And all rooms have video cameras in them and they are recording.
(17:05):
And we start that recording from the moment that you walk into the sleep room. So that way we can
kind of assess the bedtime routine that happens a little bit as well. And that makes sense. That
makes sense. And then so how does this, before we go into the sleep center, the labs itself,
how did your approach, this checking them in, setting them up, differ from one child to a child
(17:30):
that's perhaps on the spectrum? So it's really a very, I want to say kind of informal atmosphere.
And I'll show you generally, there's some decorations on the wall is a bit of a kid friendly.
It does not blatantly look like a doctor's office. And the technician greets the child
at the door. It was ultimately up to the technician to establish that record. Now again,
(17:53):
I highly encourage a sleep lab visit prior to the sleep study. If you anticipate that your child
will be anxious about the procedure and about new places in general, come in during the daytime,
have a walk through. I don't know any sleep labs that would or she was that. And if they do, you
should probably look elsewhere for a child's sleep study. That always puts them at ease. Yeah.
(18:19):
Oh, I mean, the unknown is scary, right? Especially when you're tiny, but for all of us,
it can be scary. Absolutely. And the parent, if you want to bring something to the lab beforehand,
so that your child finds it there, that can be helpful as well. So really anything that you
want to do to make your child more comfortable, everything is fair game. We ultimately want
(18:44):
to do our best to try and get the best recording we have and have it be as the least amount of stress
for your child as possible.
(19:14):
You're listening to Airway First with today's guest, Dimitri Specter. You can find out more
about the Children's Airway First Foundation and our mission to fix before six on our website at
childrensairwayfirst.org. The CAF website offers tons of great resources for both parents and
medical professionals. In our parents portal and clinicians corner areas, you can find educational
(19:37):
and informational content, including videos, blogs, our recommended reading lists, comprehensive
medical research, podcasts, events, parent support, and several educational opportunities.
Parents are also encouraged to join the Airway Huddle, our Facebook support group,
which was created for parents of children with airway and sleep-related issues.
(19:59):
You can access the Airway Huddle support group at facebook.com. Backslash Groups. Backslash Airway
Huddle. Are you a medical professional or parent that is interested in being a guest on the show?
Then shoot us a note via our contact page on our website, or send us an email directly at
infoatchildrensairwayfirst.org. As a reminder, this podcast and the opinions expressed here
(20:23):
are not a medical diagnosis. If you suspect your child might have an airway issue,
contact your pediatric airway dentist or pediatrician. And now, let's jump back into
my interview with today's guest, Dmitri Speckman.
(20:46):
And I know this is only going to be to a tiny group of our listeners, but I'm really
stretching trying to think of scenarios. But you have two tiniest, let's say they're two,
(21:10):
and they're twins. And they're used to being two-get-there, but only one's getting the sleep
study. Could the parent bring the other one if it helps calm them down? Or is that okay?
That could disrupt it. We got to figure something else out. Have you had things like that?
Absolutely. So those are case-by-case basis approach. We don't rule anything out. Generally,
(21:32):
the setup is one parent stays with one child. Now, if more than one child in a family is having a
sleep study done, two parents will need to come and stay. So you need to have one child and one
parent per room. Now, if the child is used to a sibling being in the room with them, you can
(21:54):
certainly ask the lab if that would be acceptable. And patient acceptance policies will vary slightly
from lab to lab. For example, we require a parent to stay with anybody under 18. Some labs may require
a parent to stay with somebody with anybody under 21. And that strictly facility-based policy.
(22:18):
Certainly under 18, a parent will always be required to stay unless it's an inpatient study
and the patient is checked in at the hospital. Okay. Oh, wow. I didn't even think about that.
So that's true. They could just wheel them down. But there are cases for that.
Absolutely. So there's two differences in sleep labs. There's something we have here,
(22:40):
which is a freestanding independent sleep lab. But then there's also hospital-based sleep labs.
Now, even hospital-based sleep labs, a routine sleep study will be an outpatient procedure.
So it's not going to vary much from an independent sleep lab, a freestanding one.
They also cannot administer any medication, even though they're in the hospital.
(23:03):
So in the hospital, it does not sleep well. Okay. Now, another thing that is sometimes done is
patients who are inpatients at the hospital will have sleep studies done bedside on the floor.
At that point, they're checked into the hospital and the parent does not always at bedside,
which is okay. Okay. Got it. Well, I think we have some good... So we're actually a really great,
(23:27):
great, great do's and don'ts for parents. They know what to pack. They know how to prep the child.
If you're ready, let's go into the sleep lab. Let's go. This is our front door. And I'm just
going to walk in as if I'm coming in for a sleep study. We have a reception area here.
So you generally will not spend much time in a reception area. In most sleep labs,
(23:50):
the technician will greet you at the door and show you back to your room right away.
Okay. If several patients arrive at the same time, may need to wait in the waiting area for
just a few minutes. This is not a place where you will spend much time.
So again, not like a doctor's office. No, there's no waiting. That'll help kids. Yep.
(24:11):
Correct. If there's one technician on duty, you will only be one of two appointments. If there's...
We have four bedrooms here. So if we're running more than two patients, we'll have two technicians
on duty. Okay. And then as we walk through, this is a pretty typical setup where this is the
technician's control room. And this is where we monitor from. Okay. And it is... It usually is
(24:36):
in close proximity to the reception area. And the patient rooms, there's our little
jungle animals here on this wall. And patient rooms are generally very short distance from the
control room just so that we can get to the patient quickly if needed. Okay.
(24:57):
This is the way our room is set up. So again, we have a restroom right in the room with a shower.
We have our patient bed. And we do have safety rails for the younger children.
And we have a cot for the parent to sleep on. I like how close it is though. That's got to be
comforting to the child. Absolutely. It's going to be across the room. That's awesome. So most rooms
(25:21):
are fairly cozy with not a whole lot of room to spread out. This is actually a pretty standard
sized room for a sleep study. But yeah, the parent is right next to the child. Now we can... We do
have cribs as well. We can roll a crib in if for the younger kids who are still in cribs, we will
generally swap out the cot for a crib and then the parent can sleep in the bigger bed. Okay.
(25:46):
Now next to the bed, generally you will have some equipment. Okay. And this is the recording
equipment. So we have our recording equipment here. All the sensors plug into a box that looks
similar to this. We use the Phillips Alice diagnostic system. But ultimately the setup
(26:07):
is very similar with whatever system to use. And then there's a CPAP machine
usually as well. And that is for treatment of sleep apnea. Okay. Now we have also an exam table
in this bedroom. And this is so that we can see patients during the daytime and clinic.
(26:28):
Okay. Now some sleep labs will have these. Some sleep labs will have
mercy beds that convert to exam tables. So there will be slight variations. But this kind of gives
you a general idea of the setup of the room. Now I did mention that there's a camera which
will record all night long. It does record video and audio. Oh, okay. Okay. So the technician can
(26:54):
generally hear you. We'll hear you all night long. So you can, if there's anything you need during
the night, you can always call the technician and they will come in and help you out. Okay. And
there's also intercom systems to where the technician can talk to you as well. And that is
basically it for the tour. It's very simple. It is very simple. But I mean, you could tell,
(27:17):
especially if the lights were dimmer, I could see how, okay, it's not quite as scary as a doctor's
office. No, and getting to be right there. I'm sure that's got to be very reassuring.
Absolutely. And we are able to dim the lights. We do have a dimmer switch to where if somebody's
light sensitive, we can turn it down and work in a little darker environment.
Yeah. That's what I think, especially for kids on the spectrum or something like that.
(27:42):
Light sensitivity. Do you come in, you get checked in, and then how long does it take
typically to wire up a child? So it will depend on the child. Of course. For somebody who's
cooperative, it can take anywhere from half an hour, 45 minutes. For somebody who's a little
(28:03):
less cooperative, it can go to an hour plus. Just also super curious kids that ask a lot of questions.
Well, it will take a little bit longer. Because the last thing I want to do is rush a child during
the setup. If they're asking questions and they're involved, that's always a good thing.
They're always going to do much better if they're involved. And personally, if I'm running a sleep
(28:26):
study, I try to get the kids as involved as possible in what I'm doing. Whether it's helping me put
the little stickers on them, the sensors to plugging them into the box, to letting them put,
especially the cannula, I always like to let them try and put it on themselves. It'll tickle their
(28:47):
nose a little bit, but they're in control at that point. So for kids, control is a huge thing.
Yeah. So the more control you can or more perception of control that you can give the
child the better the outcomes are. I agree with that. That's kind of the goal of life, right?
That's parenting. Absolutely. And then so if you would walk us through the morning, so
(29:08):
6, 6, 30, you go in, we wake him up. Okay. So in the morning, the technician will determine
the best type two and the study. So usually it's not set in stone. So it'll depend on how well
the child is slept through the night, how well they're sleeping towards the end of the night.
(29:29):
If it's 5, 5, 30, and I see that the child is really struggling, they're not sleeping,
they keep waking up. And if we have enough data, I will go in and I will say, hey,
they've been awake for a while, we have enough data, why don't you go home and get some rest.
Now, if there was a really long wake period in the middle of the night,
(29:54):
and then they're sleeping well towards the morning, we will try to let it run as long as possible,
just so that we can get the most data that we can from the sleep studies. So again,
6 to 6, 30 is really just a rough estimate. I have run studies to 7, 7, 30 before,
and I've ended studies at 4, 35 o'clock before as well. It can fluctuate a little bit. But general
(30:19):
rule of thumb is about 7, 7, 30 check in, sometimes even a little earlier, sometimes even 6, 30.
That's just so that you can get to the lab and so that we try to keep things as not rushed as possible.
Right. When you come in here, I want to let you settle into your room. I want to let you get
(30:40):
comfortable. I want to let the kid explore a little bit, climb all over the bed, get comfortable,
wash face, brush teeth, or whatever you do to get ready for nighttime. Get all of that out of the
way and just get comfortable and start to wind down. Which makes sense. And that's why earlier
arrival time. Now, there's some paperwork to fill out. You may be asked to come in a little bit
(31:03):
earlier. The way we do it is we like to do most things through the patient portal. So we send
everything out beforehand. And even if the paperwork's not filled in prior to the visit,
it's very easy for the parent to access the portal once they come in from a phone or from a tablet,
whatever it may be. If there's physical paperwork to fill out and it's given when you arrive at the
(31:27):
lab, you may be asked to come in a little bit earlier. I have to say, I think I'm spoiled
because of my Astrame in hospitals and doctor's offices so often. Anytime I have to go somewhere
new and they hand me paper, I just kind of like, I don't know what to do with this. Do you have a
portal? Do you have something I can type on? Because it's just so much easier. Absolutely.
It's not going to lie. It's just so much easier. I think we're all going the route of embracing
(31:52):
technology as much as possible. It's even AI involved in sleep study analysis now.
Oh, wow. Oh, that's wild. I can't wait to do a follow-up on that.
Absolutely. JT is a great person to talk to about that. He knows.
Oh, yeah. He's got his finger on the pulse. He's always at the forefront of technology.
(32:13):
He is. And for those who are in the area, it's actually JT's podcast comes out next week.
And it will be too late for you. But there is a conference next week and JT will be at that
speaking. Correct. Yes. He's speaking at the Texas Society of Sleep Professional annual meeting.
I unfortunately cannot attend that one. But I'm hoping that his talk will be recorded so I can
(32:37):
catch it afterwards. Yeah, I've heard him speak. It's great. He's such a good speaker. And obviously,
everybody listening to this now knows as well because they got introduced to him in episode one
of this series at the end of every episode. Usually, I hand it back to you, our guests,
because you are the experts and let you leave with final words. Do you have some final words that you
(32:58):
could leave with our parents? Prepare, prepare, prepare. That's all I can say.
I figured that's what it would be. Yeah. Yes. You cannot prepare too much. It's as,
it can be a very simple procedure, but it can also be a very tough one because there's about
20 of these plus that go on as well as a couple belts. There's a pulse oximeter to look at pulse
(33:24):
and oxygen levels on the finger for the younger kids will put it on the toe. So when we say wired
up from head to toe, we literally mean you made it. Yeah. So the more you can expose your children to
really have it be familiar to them, the less anxiety, less apprehension they'll have when
(33:47):
they come in. And especially the kids that are old enough to understand. Show them pictures,
get some wire samples and just start gradually introducing it a month before, a couple weeks
before, a week before, a couple days before remind them that, hey, you remember we're going to go on
this trip. We're going to spend the night out, make it fun for them, make it like vacation.
(34:12):
Yeah. Oh, I like that. And it's funny. I was just had it popped in my head too.
I'm sure other parents have done this, but you talked about put band-aids on them, right? So
they're used to having that. If you've got some yarn, why not have a little yarn stick out so they
can get used to something like the wire dangling. That is amazing. That's got to be uncomfortable,
especially for a child with sensory. That's got to be a hard thing to get used to.
(34:34):
Absolutely. Absolutely. Kids that have trouble when you touch their head, the more you can
prepare that, the better, because the majority of the sensors do go on the head and on the face.
Oh, that's good to know. Okay. Well, there you go. Now you know where to put the band-aids.
Absolutely. Yes. Yes.
Thank you so much for answering these questions, giving us great info and for the tour.
(34:55):
For so many of us, we've never seen the inside, so it's really, really
helpful as a parent to know what you're walking into.
My pleasure. Thank you so much for having me. And I hope that this really relieves some stress for
parents preparing for a sleep study. And hopefully what I said resonates. And it'll make it easier
for the technicians who will be running the studies as well.
(35:17):
My thanks, though. Yep. Thank you. Thank you, Rebecca.
Thanks again to today's guest, Dimitri Spector, for the amazing behind-the-scenes tour of the Sleep
Lab and to each of you for listening to today's episode. You can stay connected with Children's
Airway First Foundation by following us on Instagram, Facebook, X, LinkedIn, and YouTube.
(35:40):
Don't forget to subscribe to the Airway First podcast from your favorite podcasting platform,
so you won't miss an upcoming episode. If you'd like to be a guest or have an idea for an upcoming
show, shoot us a note via the contact page on our website, or send us an email directly at
info at childrensairwayfirst.org. Today's episode was written and directed by Rebecca St. James,
(36:02):
video editing and promotion by Ryan Drone, and guest outreach by Kristie Bojipin.
And finally, thanks to all the parents and medical professionals out there that are working hard to
help make the lives of kids around the globe just a little bit better. Take care, stay safe,
and happy breathing, everyone.
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