Dr. Kimberly: Everything You Need to Know About Home Sleep Studies

home sleep study

Did you know there are several brain and heart-related conditions that can contribute to poor sleep? The primary reason to do a sleep study is to determine your normal sleep patterns and gain more insight into how you breathe during sleeping. The data from a home sleep study will assist your doctor in finding ways to help you wake up 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 or various therapies.

Doctors also consider what type of test you’d prefer and what type of test your insurance covers. Some insurers have recently recommended home sleep tests for people likely to have moderate to severe Obstructive Sleep Apnea (OSA) as a cost-effective alternative to a traditional overnight sleep study.

Once your doctor has prescribed a sleep study, you’ll have to choose whether to go through a clinic, a lab or use an at-home sleep study.

Pros of a Home Sleep Study

There are many reasons to get a home sleep study, including:

  • Access to Care for Those in Rural Areas. Home sleep studies make it easier for neurologists working in clinics that are not equipped for in-office sleep studies to screen patients for sleep apnea problems. They also make the data gathering process more accessible to doctors working in smaller clinics and provide patients in rural areas a more approachable option.
  • Improved Timeliness of Study Results. Results from a home sleep study can be obtained, discussed with your primary care physician, and acted on more quickly than a sleep study done in an office setting. Researchers noted that “growing interest in [sleep apnea] has resulted in increased requests and wait times for polysomnography (PSG).” Because of the increase in sleep apnea awareness some clinics are not able to handle the volume, however, “home sleep tests [are able to] expands the diagnostic and therapeutic prowess of the practicing otolaryngologist by offering an alternative OSA testing modality that is associated with not only less expense, decreased waiting time, and increased convenience, but also statistically proven accuracy.”
  • 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. A home sleep study has the added benefit of taking place in familiar, comfortable surroundings.
  • You May Be More Likely to Complete a Home Sleep Study.  Home sleep studies are typically available anytime and therefore fit into any schedule. And with almost 80% of Obstructive Sleep Apnea (OSA) patients failing to receive an accurate diagnosis, at-home sleep studies can remove previous boundaries, such as scheduling conflicts, allowing more people to seek the treatment they need. Ultimately, you know your best sleeping time, and a home sleep study can accommodate that timing.

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. The sleep study comes in a kit with a few different sensors, each for measuring different things. Typically, you will get:

  • Electrodes for the chest (soft electrodes that conform to the wearer’s skin).
  • A small oxygen sensor probe to be placed over the participant’s finger.
  • A chest belt to measure breaths and, if needed, sleep position.
  • A nasal cannula to measure airflow. This is a mask with tubes that go into the nostrils and is secured around the ears, similar to an oxygen mask.

All of these sensors are hooked up to a tiny computer, recording the data. When the night is over, the data is sent back to the sleep lab for analysis, and the results are sent to the physician or primary care provider. Your doctor can then discuss a diagnosis with you.

Per the American Academy of Sleep Medicine (AASM) clinical guidelines, the proper OSA evaluation requires portable monitoring equipment that records at least:

  • Airflow (pressure-based)
  • Pulse oximetry
  • Heart rate
  • Respiration effort measured via respiratory inductive plethysmography (Type III monitor)

Your doctor can help you pick a home sleep study that is small, light and allows for easy self-administration.

A 2017 study found home sleep test results comparable to sleep lab results for several parameters. “There was no difference between home and hospital assessment of mean sleep latency,” noted researchers. “Group mean sleep latency for home modified-multiple sleep latency tests seemed to be reliable compared with that for the attended sleep-laboratory setting.”

Higher rates of sleep-onset rapid eye movement periods in the unattended home study suggest that sleeping in a familiar environment facilitates the transition into REM sleep.

Another study noted that “sleep on the polysomnography (sleep study in a lab) night was significantly worse than that two and three nights later.” People who had a worse sleep were:

  • Older
  • Had a higher apnea-hypopnea index
  • Had a worse neuromuscular function
  • Had more depressive symptoms

If your home sleep study is inconclusive, or another disorder is suspected, an overnight sleep study at a sleep lab may be done as a follow-up.

How to Prepare for a Home Sleep Study

The goal of a sleep study is to learn what happens when you are sleeping—the key piece being “when you are sleeping.”  When you’re at home, you’ll be able to fall asleep faster because you’ll feel comfortable. Therefore, conducting these tests at home can help ensure that you are able to sleep as relaxed as possible, ensuring accurate results. 

The day of the test, you should not nap, consume caffeine, or drink alcohol. Doing so can make it harder to fall asleep, and consuming caffeine and alcohol can interfere with the data a sleep study collects.

Before bed, try to relax by following your typical bedtime routine. It can be intimidating not knowing what to expect; below is an outline of the steps typically taken to set up your home sleep test device:

  1. You’ll fasten the belt with the recorder attached across your upper chest.
  2. Fit the nasal cannula into your nostrils,
  3. Secure the nasal cannula loop around your ears and tighten under your chin to adjust to a comfortable position,
  4. Then, you’ll attach a self-adhesive finger pule sensor to the ring finger on your non-dominant hand.
  5. Lastly, you’ll hit “start” on your recorder device. When you wake up in the morning, you’ll hit stop. Some tests require two nights to ensure they are able to provide you with the most accurate results.

Why You Should Consider a Sleep Study

Still not sure you need a sleep study? Sleep studies are a key tool in diagnosing a myriad of sleep disorders. Below are a few additional risk factors associated with sleep disturbances and insomnia:

  • 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: Another 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 carers.”
  • Waking Up Headache Free: You might consider a home sleep test if you wake up tired, with a headache, or with dry mouth, as obstructive sleep apnea could be to blame. This happens when your breathing is interrupted during sleep, often for more than 10 seconds at a time.
  • Diagnosing Mucopolysaccharidoses (MPS): Researchers noted that a home sleep study is a quick and accessible screening test “to determine the abnormalities of breathing during sleep and enables clinicians to take necessary action for patients with severe manifestations.”
  • Diagnosing Restless Legs Syndrome or Narcolepsy: A sleep study is ultimately a way for doctors to diagnose several sleep disorders, including sleep apnea, restless legs syndrome, and narcolepsy.
  • Diagnosing Myasthenia Gravis: A sleep study gives information that may help people with myasthenia gravis.
  • Diagnosing Marfan’s Syndrome: Sleep studies can indicate whether the person has sleep apnea and could benefit from a maxillary expansion or mandibular advancement is indicated in Marfan’s syndrome.

Talk to Your Health Provider

If you have signs or symptoms of sleep apnea and/or sleep concerns, contact your primary healthcare provider to discuss whether a home sleep study can help you feel better.

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