Module - Sleep and Long-term Monitoring


Work-based learning outcomes


  1. Prepare, plan and perform multiple sleep latency tests (MSLT) and/or polysomnography (PSG)
  2. Prepare, plan and perform videotelemetry and/or ambulatory EEG recordings
  3. Factually report on the results from MSLT and/or PSG
  4. Factually report on the results from video telemetry and/or ambulatory EEG recordings

Work-based Competencies


Learning outcome Title Knowledge
1 1,2

Control infection risks in accordance with departmental protocols

  • Protocols and requirements for hygiene and infection control related to the relevant range of investigations, including preparation, conduct and completion of investigation
  • Protocol for hand washing and how effective hand washing contributes to control of infection
2 1,2

Minimise risks and hazards in compliance with health and safety policies

The relevant health and safety regulations specific to neurophysiology investigations, the potential hazards and risks, and the actions to be taken to minimise these

3 1

Plan and prepare for the sleep investigation (multiple sleep latency test (MSLT) and/or polysomnography (PSG)

  • The physiology of sleep and normal and abnormal sleep patterns in EEG
  • The range of conditions of patients referred for sleep studies
  • The pathophysiology of sleep disorders
  • Special needs of patients undergoing sleep studies
  • The referral system and the justification for sleep studies
  • The range and types of information required and its importance
  • Information that should be recorded and the checks for validity
  • Appropriate action to be taken in the event of missing or invalid information
  • The purpose of sleep studies and their appropriateness for the conditions presented
  • The importance of confirming the patient’s identity from the referral document and correct entry on the recording system
  • Possible patient needs and environmental needs
  • Factors that may influence the duration and quality of investigations
  • The specific environmental hazards
  • The effect of medication on the EEG
  • Safe and correct operation of the equipment to be used, including all peripheral devices
  • The importance of confirming the patient’s identity from the referral document and correct entry on the recording system
  • The importance of establishing and maintaining effective communication with the patient
  • The importance of checking there is adequate storage volume for the investigation to be performed
  • The effects of sensitivity, display speed, filters, CMRR and sampling rate
  • The range of electrodes and transducers used in sleep studies
  • Factors of key importance to patient history
  • Information that should be recorded and the checks for validity
  • Selection of appropriate electrodes and transducers
  • Quantity and type of consumables required for the investigation
  • Confirmation of the patient’s identity and match to the referral documents
  • Correct entry/identification of patient details on the recording system
  • Recognised measuring systems and how they may need to be adapted for sleep studies
  • Correct use, placement and parameters of additional transducers
  • Appropriate contact impedances
  • The needs of the patient and the recording environment for the required investigation
  • Recording parameters and protocols for the planned investigation
  • The requirement for ongoing communication with medical, nursing staff and/or patient as appropriate
4 2

Plan and prepare for long-term monitoring and/or ambulatory EEG recording

  • Epilepsy and other seizure disorders
  • Special needs of patients undergoing long-term monitoring
  • The referral system and the justification for long-term monitoring
  • The range and types of information required and its importance
  • Information that should be recorded and the checks for validity
  • Appropriate action to be taken in the event of missing or invalid information
  • The purpose of long-term monitoring and its appropriateness for the conditions presented
  • The importance of confirming the patient’s identity from the referral document and correct entry on the recording system
  • Possible patient needs and environmental needs
  • Factors that may influence the duration and quality of investigations
  • The specific environmental hazards
  • The effect of medication on the EEG
  • Safe and correct operation of the equipment to be used, including all peripheral devices
  • The importance of confirming the patient’s identity from the referral document and correct entry on the recording system
  • The importance of establishing and maintaining effective communication with the patient
  • The importance of checking there is adequate storage volume for the investigation to be performed
  • The effects of sensitivity, display speed, filters, CMRR and sampling rate
  • The range of electrodes and transducers used in long-term monitoring
  • Factors of key importance to the patient history
  • Information that should be recorded and the checks for validity
  • Selection of appropriate electrodes and transducers
  • Quantity and type of consumables required for the investigation
  • Confirmation of the patient’s identity and match to the referral documents
  • Correct entry/identification of patient details on the recording system
  • Recognised measuring systems and how they may need to be adapted for long-term monitoring
  • Correct use, placement and parameters of additional transducers
  • Appropriate contact impedances
  • The needs of the patient and the recording environment for the required investigation
  • Recording parameters and protocols for the planned investigation
  • The requirement for ongoing communication with medical, nursing staff and/or patient as appropriate
5 1,2

Explain the procedures for investigations to the patient and address any questions they may have relating to the procedure, including the process after the procedure and how the patient will be informed of the results

  • The appropriate choice of investigation considering the findings from the history and clinical examination
  • Common questions and concerns of patients about procedures
  • Risks and benefits of undertaking the investigation
  • The information needs of patients following investigation
  • The authority level for provision of information to patients
6 1,2

Gain informed consent for each type of investigation

  • The importance of explaining the procedure for each investigation to the patient and gaining informed consent
  • The relevant procedures and requirements for patient conformance
  • Principles, guidance and law with respect to informed consent
7 1,2

Accurately measure electrode sites and site electrodes usingrecommended placement system for EEG, electro-oculography (EOG) and sub-mental muscle, electrocardiogram (ECG) and respiratory etc as required

  • Principles of derivation of montages (referential and bipolar) and electrode placement used for sleep studies and long-termmonitoring
  • The importance of electrode impedance and its effects
8 1,2

Perform the investigation (MSLT and/or PSG, ambulatory EEG and/or videotelemetry)

  • The importance of a range of control settings and of reviewing throughout the recording
  • Correct recording parameters
  • The use of activation or provocation procedures
  • The need to modify or extend the current investigation
  • Annotation of ongoing recording, including by external parties
  • Recognition of and the correct response to clinical events
  • Recognised sleepiness scales
  • Protocols and requirements for hygiene and infection control related to the relevant range of investigations
9 3,4

Recognise normal EEG features (wake and sleep) and abnormal EEG features observed in epileptic syndromes and sleep disorders

  • Normal wake and asleep EEG features
  • Abnormal EEG features observed in epileptic syndromes and sleep disorders
10 3,4

Produce a factual report from the investigations performed (MSLT and/or PSG, video telemetry and/or ambulatory EEG recording) pertinent to the investigation required

  • Correct annotation of recordings and other patient documentation and the importance of accuracy, legibility and completeness
  • Normal and abnormal features in EEG, awake and asleep
  • Manipulation of data
  • Drug therapies commonly seen in patients with sleep disorders or conditions requiring long-term monitoring
  • Sleep scoring and staging methodologies used for MSLT and PSG, eg Rechtschaffen and Kales
  • Identification of the degree of urgency of clinical report

Work-based assessment


Complete 3 Case-Based Discussion(s)
Complete 2 of the following DOPS and/or OCEs
Type Title
DOPS Perform multiple sleep latency test or polysomnography
DOPS Prepare, plan and perform video telemetry and/or ambylatory EEG recordings
DOPS Perform ambulatory EEG or long term monitoring
DOPS Factually report on the results from mulitple sleep latency tests (MSLT) and/or polysomnography (PSG)
DOPS Factually report on the results from video telemetry and/or ambulatory EEG recordings
DOPS Minimise risks and hazards in compliance with Health and Safety policies
OCE Obtain patient history
OCE Obtain informed consent
OCE Apply electrode/transducers according to local procedures
OCE Analyse and sleep score multiple sleep latency test or polysomnography
OCE Analyse and write factual report on ambulatory EEG or long term monitoring
OCE Measure electrode sites and site electrodes using recommended placement systems for EEG, EOG and sub mental muscle, ECG and respiratory ets as required
OCE Apply electrode/transducers according to local procedures taking into account factors require for patients to keep electrodes on safely for prolonged periods
OCE Explain procedure and the risks and benefits with respect to the patients comorbidities and medication to the investigation to obtain written and informed consent
OCE Remove all electrodes and transducers safely and causing patient minimal discomfort
DOPS Plan and prepare for long term monitoring and/or ambulatory EEG recording