How Will Acrylic Nails or Nail Polish Affect My Sleep Study?

The nail industry grew to $7.47 billion in 2012. In California alone, there were almost 8,000 nail salons.

Many of the patients we schedule for in-center and in-home sleep studies wear nail polish, gels or acrylics. 

Our customer service department is frequently asked whether nail polish, gels or acrylics will interfere with testing.

Jonathan Sherrill, RPSGT, is the technical director of Advanced Sleep Medicine Services, Inc. In this post, he answer this question and offers and some background.

Why do artificial nails and nail polishes interfere with sleep studies?

Sleep apnea is the cessation of breathing during sleep that leads to reduced oxygen flow and poor quality sleep. When oxygen levels dip during sleep apnea, the brain signals the body to partially wake up. The person’s sleep is disturbed and s/he is never allowed to sink into deep, restorative sleep stages. People with severe sleep apnea can go through this process hundreds of times each night. Often, people do not remember this happening and think that they have slept as normal. However, they wake up feeling exhausted, groggy, and unrested.
People suffering from sleep apnea deal with not only the negative effects of sleep deprivation, but also the strain of trying to cope with oxygen deprivation at night. This puts serious strain on the brain, the heart, and the rest of the body (learn more about the consequences and effects of sleep apnea here). 
Sleep studies are used to diagnose sleep apnea and many other sleep disorders. During the sleep study, many channels are monitored, including your oxygen saturation (learn more about the types of sleep studies and the disorders they diagnose here).
The equipment used to get your oxygen reading during your sleep study, whether overnight or daytime in a sleep center or in-home, is called a pulse oximeter. It is a simple sensor that is usually place on a fingertip or another part of the body that is far away from the heart, such as a toe or earlobe. It measures how much of the hemoglobin in blood is carrying oxygen, this is called oxygen saturation or SaO2. The sensor in the pulse oximeter works works out the oxygen saturation by emitting red light that goes across the the probe, through the finger and to a light detector on the other side. Part of the light is absorbed by the finger and part not absorbed reaches the light detector.
Wearing artificial nails can be an issue with sleep studies because acrylic creates a barrier between the sensor and the blood in your finger. Even less of the light will reach the light detector.

Additionally, color effects absorption of sensor. So, depending on the color of the nail polish, this can affect the ability of the sensor to accurately measure your blood oxygen. Red nail polish is the worst. 

Red acrylic nails are a double whammy.

What’s the worst that could happen?

It’s more of a problem in the way the sensor work. Nothing would blow up or melt down if a patient has nail polish on during a sleep study. Just an impaired signal. Only a few times have I seen it fail all together but most often we can filter through it and obtain usable data from the study to complete a useful report.

If a patient tests with acrylics or nail polish, it’s possible that the starting oxygen reading (called SaO2 value) will be lower than actual baseline. What we’re looking for in the study is any change from the baseline.

If there was any issue with the oxygen reading during the study, the sleep technician would see the signal and should be able to correct it ahead of a failure.
If the nails are too obstructed, the technician may be able to switch the pulse oximeter to a toe or an earlobe.

If no signal could be obtained during polysomnography, the study would be canceled due to technical issues in place of continuing the recording and repeating. A sleep study is invalid without oximetry.

Do I have to remove my nail polish, gels or acrylics before my sleep study?

It is preferred that you not have acrylic nails or remove them before the study, but we can do the sleep study with them still on. Similar to acrylic nails, it is preferred that red nail polish be removed (and this is quite a bit easier than removing acrylics). 

Do you need to schedule a sleep study to rule out or diagnose a sleep disorder? 

Other posts you may find interesting:

Leave a Comment