The primary reason to do a sleep study is to determine your normal sleep patterns and gain more insight into how you breathe during sleep, but did you know that there are several brain and heart-related conditions that can also contribute to poor sleep? The data from a home sleep study will assist your doctor in finding ways to help you wake up feeling more refreshed and feel better throughout the day. Armed with more information about your sleep patterns, you can then address any issues using sleep apnea equipment.
When deciding to do a sleep study, doctors also consider what type of test you prefer and what type of test your insurance covers. Some insurers have recently recommended home sleep tests for people likely to have sleep apnea as a cost-effective alternative to a traditional overnight sleep study. You may already be familiar with Obstructive Sleep Apnea (OSA) as it’s normally the term synonymous with the all-encompassing term sleep apnea, but there are three different types of sleep apnea: OSA, Central Sleep Apnea (CSA), and Complex (mixed) Sleep Apnea.
Once your doctor has prescribed a sleep study, you’ll have to choose whether to use a clinic, a lab, or an at-home sleep study.
What Is a Sleep Study?
Polysomnography—more commonly known as a sleep study—is the gold standard for diagnosing sleep disorders including sleep apnea, restless leg syndrome, and narcolepsy. To perform the test, electrodes are placed on the scalp, the outer edge of the eyelids, and to the skin on the chin.
The test records your brain waves, heart rate and breathing, the oxygen level in your blood, and eye and leg movements. Characteristic patterns are recorded during three stages: while you are awake, while your eyes are closed, and while you are asleep. A sleep study also records how long it takes to fall asleep, the amount of time it takes to enter the REM cycle, and your body movements, breathing patterns, and overall sleep architecture.
What Is a Sleep Lab or Sleep Clinic?
Sleep labs, also called sleep clinics or sleep centers, are a designated place where individuals can go to have sleep studies performed. Sleep labs conduct in–house analysis of breathing, heart rate, oxygen levels, and even neurological activity. For the most part, sleep studies can be performed at home, though some cases may require a person to go to a sleep lab to test for certain conditions.
How Is Sleep Apnea Diagnosed?
When obstructive sleep apnea (OSA) is suspected, a sleep study is conducted.
Gasping for air, suddenly losing your breath while sleeping, and snoring are indicators that you may have sleep apnea. (Many conditions can lead to snoring, though, so it is not an absolute symptom of sleep apnea.) Other signs and symptoms include headaches, daytime exhaustion, drowsiness, lack of concentration, lack of energy, moodiness, decreased sex drive, acid reflux, increased urination at night, chest pain, anxiety, and depression.
A polysomnogram is performed overnight in a sleep lab by a sleep technologist who will observe for breathing patterns, body movements, and other characteristics representative of sleep apnea.
If you are diagnosed with OSA, we encourage you to visit our free online forum, CPAPtalk.com, for sleep therapy advice and personal experiences from over 40,000 individuals diagnosed with sleep apnea.
What Are Some Common Terms Used in a CPAP Diagnosis?
Knowing the ins and outs of OSA can help you make the most of your sleep therapy—and that includes common CPAP terminology. Becoming familiar with these definitions can contribute to the success of your CPAP journey.
How Much Does a Sleep Study Cost?
Depending on the location of the testing center and your health insurance coverage, an overnight sleep study can cost anywhere between $600 and $5,000. The average cost of a sleep study is around $1,000 to $2,000, and most insurance companies—including Medicare—will cover the most of this expense.
Home sleep studies are becoming increasingly popular because they cost much less than tests conducted in a sleep lab and can be completed in the comforts of home. A home sleep test can cost as little as $125 depending on your current health insurance coverage.
Do Sleep Studies Require a Prescription?
Yes, a sleep study is considered a medical procedure and requires an order from a physician whether you are having the sleep study done in a sleep center or at home. At CPAP.com, we are committed to working with your doctor to ensure you can access any sleep study or any subsequent sleep therapy products you need.
What if I’m Unable to Sleep During My Sleep Study?
This is a common worry for some individuals scheduled for a sleep study, but most people are able to fall asleep whether attending a sleep study in a sleep lab or at home. Sleep studies performed in a sleep center typically allow you to bring in comfort items from home—like a pillow, blanket, or book to read—to make falling asleep easier.
The fear of not being able to sleep is understandable and can cause anxiety for some individuals. Pretending the sleep lab is a hotel room might help quell some of the anxiety. While some people may not sleep well in the sleep lab, most people get enough zzz’s to provide their physician with the data needed to make a diagnosis.
What Questions Should I Ask About My Sleep Study?
Being informed about the sleep study process and any subsequent diagnosis is an important step in managing your health. Be sure to ask your sleep specialist the following:
- Did I have any central apneas? How many?
- Were there any comorbidities? What were they?
- Did I breathe or leak through my mouth? How often? What do you recommend to prevent it?
- Did I exhibit positional sleep apnea (PSA)? Was my apnea more severe in one sleeping position compared to others? Is my pressure requirement higher in one position compared to others?
- Is there anything else unusual about my results?
- How will I know my therapy is preventing apneas?
- I would like to own a data–capable machine and accompanying software to monitor apneas, hypopneas, and mask leaks. Will you help me with the appropriate prescription?
In addition to these questions, get a copy of your sleep study (PSG) and CPAP prescription. Be sure the prescription is for a machine with a humidifier.
Are At-Home Sleep Studies Accurate?
Yes, at-home sleep studies are accurate tests that are easy to take in the comfort of your home. There is speculation suggesting that home sleep tests can under-diagnose the severity of your sleep apnea, although these claims stem from the fact that a lab has capabilities the home sleep test does not, such as neurological equipment to measure brain activity. However, the American Academy of Sleep Medicine (AASM) clinical guidelines suggest that the proper OSA evaluation requires portable monitoring equipment that records at least:
- Airflow (Pressure-Based)
- Pulse Oximetry
- Heart Rate
- The Changes in the Amount of Air You Breathe In and Out While Sleeping
Who Qualifies for a Home Sleep Test?
Theoretically, any person ages 18 to 65 who are experiencing difficulties with their sleep or are at risk of some form of sleep apnea can have a home sleep test. In some cases a home sleep study may not be the best way to diagnose your sleep apnea, but why is that? Daytime tiredness and trouble concentrating may point to sleep apnea, but they may also point to other conditions related to breathing and blood pressure such as congestive heart failure or hypertension. If you experience symptoms related to those conditions in addition to those related to possible signs of sleep apnea, disclose them and any others to your physician to discuss if an at-home test is right for you.
Advantages of a Home Sleep Study
There are many reasons to get a home sleep study, including:
- Access for Those in Remote Areas. Clinics in remote areas are often designed to treat general medicine and may not always have room to conduct sleep tests. As a result, people living in remote areas often must travel to the nearest sleep lab which can be hours away.
- Improved Timeliness of Study Results. Results from a home sleep study can be obtained, discussed with your primary care physician or sleep specialist, and acted on more quickly than a sleep study done in a lab setting. As more data becomes available about the long-term benefits of CPAP therapy, clinics have been hard-pressed to keep up with the volume of requests for sleep studies in a lab, formally known as a polysomnography (PSG) test. The COVID-19 pandemic has also limited in-person visits and when you combine that with a 2017 study that found home sleep test results are comparable to sleep lab results for several parameters, it’s easy to see why at-home sleep studies have grown in popularity.
- More Cost-Effective. Home sleep studies are also typically less expensive, costing as little as $125, while sleep studies done in a lab can cost between $600 to $5,000.
- You May Be More Likely to Complete a Home Sleep Study. Home sleep studies are typically available anytime and therefore, fit into any schedule. With almost 80% of OSA patients failing to receive an accurate diagnosis, at-home sleep studies can remove previous boundaries, such as scheduling conflicts, which allows more people to seek the treatment they need. Ultimately, you know your best sleeping time, and a home sleep study can accommodate that timing.
Disadvantages of a Home Sleep Study
Home sleep studies offer several benefits, but they do have a few disadvantages over in-lab sleep tests:
- Not Everyone Is Eligible. A home sleep study can work for most of those who suspect they have some form of sleep apnea, but as with most therapies, those with certain conditions related to breathing, heart, or blood pressure may not be good candidates for a home sleep study. Disclose your health history to your physician to assess whether or not you’d be a good candidate.
- No Brain Activity Is Recorded. What happens in your brain during sleep is part of understanding sleep. One disadvantage of a home sleep study is that brain activity isn’t recorded. However, a diagnosis compliant with AASM guidelines can be made through a home sleep study.
- No Technical Support. Home sleep testing devices are simple and durable, so the odds of malfunction in the middle of the night are low. Most include instructions on troubleshooting easy-to-solve problems, but in the event something more serious happens with the device, you will need to contact your provider and make arrangements to exchange devices or see if they can walk you through fixing the problem.
How Does a Home Sleep Study Work?
Many sleep studies are done in a sleep lab and comprehensively measure disturbances in your sleep. Sleep labs conduct an in-house analysis of breathing, heart rate, oxygen levels, and can even measure neurological activity in your brain related to your breathing and sleep.
A home sleep apnea test, on the other hand, involves a simplified breathing monitor that tracks your breathing, oxygen levels, and breathing effort.
In addition to being approved by the AASM, sleeping in a familiar environment facilitates the transition into rapid eye movement periods (REM) sleep easier, which is observed by higher rates of sleep-onset REM periods in the home sleep study participants against counterparts in the in-lab environments. A study backs this up by noting that participants of a PSG test actually experienced better nights of sleep two or three days after their night in the lab.
Your doctor can help you pick a home sleep study device that is small, light, and allows for easy self-administration. You’ll typically receive:
- Electrodes for Your Chest (Soft Electrodes That Conform to Your Skin)
- A Small Oxygen Sensor Probe to Be Placed Over Your Finger
- A Chest Belt to Count Your Breaths and, if Needed, Sleep Position
- A Nasal Cannula to Measure Airflow. This Is a Mask With Tubes That Goes into Your Nostrils and Is Secured Around Your Ears, Similar to an Oxygen Mask
All of these sensors are hooked up to a small device about the size of a smartphone that records the data. When the night is over, you send the machine back to the sleep lab for analysis, and the results are sent to the physician to discuss your results, diagnosis, and treatment options.
Though rare, your home sleep study may be inconclusive or another disorder is suspected. In those cases, your doctor may prescribe an overnight sleep study at a sleep lab as a follow-up.
How to Prepare for a Home Sleep Study
The goal of a sleep study is to learn what happens with your breathing when you sleep. You’ll fall asleep faster at home because you’ll feel comfortable. Therefore, conducting these tests at home can help ensure that you are able to sleep as relaxed as possible and ensure accurate results.
Do not nap, consume caffeine, or drink alcohol on the day of the test as doing so can make it harder to fall asleep. Consuming caffeine and alcohol can interfere with the data a sleep study collects. Follow your typical bedtime routine and relax—it can be intimidating not knowing what to expect from the test but know that you are making an investment in a healthier future for you.
Where Can I Have a Sleep Study Performed if I Don’t Want to Have it Done at Home?
Visit CPAPtalk.com, our free online forum where over 40,000 CPAP users share sleep therapy advice, discuss industry developments, and celebrate the latest products. From there, you can find a sleep lab in your area. To locate a nearby sleep center, enter your address or zip code.
Still Not Sure You Need a Sleep Study?
Sleep studies can also be beneficial in diagnosing other sleep disorders and health conditions, such as:
- Diagnosing Restless Leg Syndrome or Narcolepsy. Several sleep disorders may also be diagnosed via a home sleep study, including restless leg syndrome or narcolepsy.
- Reducing Stroke Risk. Strokes are also associated with sleep apnea. Meta-analyses reported that “more than 50% of patients who have had a stroke suffer from moderate to severe sleep apnea.”
- Decreasing Dementia Risk. A study noted the prevalence of sleep apnea in people with dementia stating, “sleep disturbances and insomnia occur frequently in people with dementia and are associated with a number of problems for affected persons, relatives, and careers.”
- Waking Up Headache Free. If you wake up tired, with a headache, or with a dry mouth, a home sleep test may help determine whether or not you are having these symptoms as a result of OSA.
- Rare Diseases and Disorders. Sleep studies have also proven to help learn more about rare conditions, such as mucopolysaccharidoses (MPS), myasthenia gravis, and Marfan syndrome.
Talk to Your Health Provider
Once you and your primary healthcare provider decide that a home sleep study is right for you, visit our home sleep test center to learn more about how a better night of sleep can lead to a healthier you.
Taylor has seen sleep apnea treatment first-hand and has learned the ins and outs through formal training in CPAP machines, masks, and equipment. She strives to make learning about sleep apnea and sleep apnea therapies a breeze. Interested in sharing your story or have a topic you’d like CPAP.com to investigate? Contact us!