The PES is a method of measuring the effort of breathing. It stands for Pressure in the Esophagus and it measures exactly that, the pressure in the esophagus. As a person increases the effort of breathing there is a corresponding increase in the vacuum created within the chest (negative pressure) and this is measured by a catheter in the esophagus. This is the most reliable method of measuring the effort of breathing during sleep.

Disorders such as the Upper Airway Resistance Syndrome in many patients can only be accurately diagnosed with the PES.

Some patients have breathing problems that are not accurately detected using the standard methods of sleep testing. Using the PES provides a more accurate method of breathing measurement and it is sometimes necessary in order to establish a proper diagnosis.

See a video of pediatric PES here: Pediatric PES placement

Video EEG monitoring is an extended type of EEG (brain wave measurement), with about 16 EEG electrodes placed on the scalp. This provides a more detailed assessment of brain wave activity and is needed to properly assess the brain waves when there is a concern of possible seizures.

Routine sleep testing does not provide enough EEG channels to properly evaluate for seizure events.

In order to demonstrate proper training in Sleep Medicine a physician should take the Sleep Board exam. Many doctors who are providing sleep testing services to patients are NOT board certified as sleep specialists.