Are At-Home Sleep Studies Accurate?

If you’ve been thinking about getting a home sleep study, you’re not alone. Home sleep studies are becoming increasingly popular, as they offer a more convenient and comfortable alternative to traditional overnight hospital stays for sleep testing.

But are they accurate? And what do you need to know before you get one?

In this post, we’ll answer all your questions about home sleep studies so that you can make an informed decision about whether or not a home test is right for you.

What is an at home sleep study?

An at-home sleep study is a diagnostic tool used to evaluate sleep disorders, particularly sleep apnea, from the comfort of one’s own home. It involves the use of portable monitoring equipment that records airflow (pressure-based), pulse oximetry, heart rate, and changes in the amount of air you breathe in and out while sleeping. The purpose is to provide you with a full report measuring your actual sleep quality.

In-home sleep studies are self-administered, less expensive than a sleep study conducted in a clinic, and often covered by insurance. They are just as accurate as testing performed in a sleep center and have a high rate of precision when diagnosing the existence and even the severity of sleep apnea and other sleep disorders or insomnia. The requirements for an in-home sleep study are less onerous than for an in-lab study, and patients can schedule them for any day that is convenient.

What are the different types of at home sleep studies?

There are several types of at-home sleep studies available for patients to diagnose sleep disorders, particularly sleep apnea. The WatchPAT is an example of a home sleep study that has an 89% match with in-lab results. The American Academy of Sleep Medicine recommends that a proper OSA evaluation requires portable monitoring equipment that records airflow (pressure-based), pulse oximetry, heart rate, and changes in the amount of air you breathe in and out while sleeping.

An at-home sleep study is a great option for anyone who suspects they may be suffering from a sleep disorder, especially sleep apnea. These self-administered tests record physiological information during one or multiple nights using equipment provided to the patient. The equipment includes sensors that register events such as apnea and measure biometric data such as oxygen saturation, airflow, and respiratory effort.

However, it is worth noting that at-home sleep tests cannot diagnose central or complex sleep apnea, and a lab sleep study will be more comprehensive. Nonetheless, an at-home sleep study is a less expensive, more comfortable, and less anxiety-inducing option.

At-home sleep studies are typically conducted using portable monitoring devices. Here are some common types of at-home sleep studies:

1. Home Sleep Apnea Testing (HSAT): HSAT is the most commonly performed at-home sleep study. It involves the use of portable monitoring devices to assess breathing patterns, oxygen levels, and heart rate during sleep. HSAT is primarily used for diagnosing obstructive sleep apnea in individuals with a high likelihood of the disorder.
2. Actigraphy: Actigraphy is a method of monitoring sleep-wake patterns and activity levels using a device worn on the wrist. It measures movement during sleep and light exposure to estimate the sleep duration and quality. Actigraphy is often used to gather long-term sleep data in research studies or to assess sleep patterns in individuals with circadian rhythm disorders.
3. Respiratory Effort Related Arousals (RERA) Monitoring: RERA monitoring focuses on assessing the respiratory effort-related arousals during sleep. It involves the use of a portable device that records respiratory signals, such as chest and abdominal movements, to identify arousals that may be associated with respiratory events.
4. Single-Channel Sleep Study: This type of at-home sleep study uses a portable device to monitor specific sleep parameters such as breathing patterns, oxygen saturation, and heart rate. It is a simplified version of polysomnography and is often used to screen for sleep-disordered breathing or monitor treatment efficacy. Read more about how to sleep with a CPAP machine.

What are the benefits of at-home sleep studies?

At-home sleep studies offer several benefits for those who suspect they have a sleep disorder, particularly sleep apnea.

• These studies can be performed in the comfort of your own home, making them more convenient, accessible, and less time-consuming.
• At-home sleep studies are also more affordable than in-lab sleep studies. With an at-home study, you can measure your breathing and other sleep factors, providing a more accurate reading of how you actually sleep.
• Home sleep studies also remove barriers for people who are reluctant to spend time in a sleep lab, leading to more effective control of sleep disorders.
• While there are limitations to what a home sleep study can reveal, an accurate diagnosis compliant with AASM guidelines can be made through a home sleep test.

Overall, at-home sleep studies are a viable and beneficial option for those seeking to diagnose and treat sleep disorders.

What are the drawbacks of at-home sleep studies?

At-home sleep studies are a convenient option for those who suspect they may have sleep apnea, but they do have some drawbacks.

• One of the main limitations of at-home tests is their potential for less accuracy compared to in-lab sleep studies.
• At-home tests may miss a sleep apnea diagnosis and cannot collect as much data, such as brain waves, as in-lab tests.
• at-home tests lack the support of trained sleep professionals who can provide advice or adjust equipment.
• External factors such as noise or movement may also affect the accuracy of results.

It’s important to disclose your health history to your physician to assess whether or not you’d be a good candidate for an at-home sleep study.

How accurate are at-home sleep studies?

At-home sleep studies prescribed by a doctor are generally very accurate, with some studies boasting up to 89% accuracy when compared to in-lab studies. However, the accuracy of the results can depend on factors such as

• the type of sleep disorder being tested for,
• the technology used in the test,
• and the qualifications of the test administrator.

Home sleep studies are particularly useful for diagnosing

• obstructive sleep apnea,
• central sleep apnea,
• circadian rhythm disorders,
• and other sleep conditions with persistent symptoms that are difficult to control.

While at-home sleep studies can be very accurate, it’s important to carefully follow the instructions for their use. Your doctor should show you exactly how to use the machine before you start the test, and if data is missing or inaccurate, most devices are calibrated to show that the overnight test failed. This allows you to perform the test again from the beginning the next night.

Are home sleep apnea tests reliable?

Home sleep apnea tests (HSATs) can be reliable for diagnosing obstructive sleep apnea (OSA) in certain cases. However, it’s important to note that the reliability of HSATs depends on several factors, including the type of device used, the accuracy of the measurements, and the proper interpretation of the results. Here are some considerations regarding the reliability of HSATs:

1. Accuracy of Devices: HSAT devices vary in terms of their design, sensors used, and data collection capabilities. High-quality devices that have been validated and approved by regulatory authorities tend to be more reliable in providing accurate measurements. However, not all HSAT devices may be as accurate as in-lab polysomnography, which is considered the gold standard for sleep apnea diagnosis.
2. Diagnostic Accuracy: HSATs are generally more reliable in diagnosing moderate to severe cases of OSA. They are effective in detecting significant breathing abnormalities and oxygen desaturations during sleep, which are characteristic of sleep apnea. However, HSATs may have limitations in accurately diagnosing milder cases or other sleep disorders that require more comprehensive evaluation.
3. User Compliance: The reliability of HSAT results also depends on the user’s compliance with the testing instructions. Proper placement of sensors, adherence to wearing the device throughout the night, and avoiding external factors that may interfere with the data collection (e.g., excessive movement) are important for obtaining reliable results.
4. Interpretation by Experts: The interpretation of HSAT results is crucial and should be done by qualified sleep specialists or healthcare professionals. They assess the recorded data, review sleep-related symptoms and medical history, and consider other clinical factors to provide an accurate diagnosis. Expert interpretation ensures that the results are correctly analyzed and any confounding factors are taken into account.

In summary, while HSATs can be reliable for diagnosing sleep apnea, they may have limitations in certain cases. If an HSAT raises suspicion of sleep apnea or other sleep disorders, further evaluation with an in-lab polysomnography or a comprehensive sleep study may be recommended to confirm the diagnosis and provide more detailed information about sleep patterns and associated parameters.

How to do sleep study at home?

To conduct a sleep study at home, you will need a sleep study device that includes a nasal tube, an adjustable belt, and a finger sensor. Follow these steps to set up the equipment and position yourself for accurate results:

1. Schedule the test for a time that works for you and avoid caffeine and alcohol before the test.
2. Pick up the sleep study device from your physician’s office or have it delivered to your home.
3. Read the instructions carefully and make sure you understand how to operate the device.
4. Attach the nasal tube to your nose, the adjustable belt around your chest, and the finger sensor to your finger.
5. Position yourself in your bed as you normally would and go to sleep.
6. Try to maintain a regular sleep schedule according to your own chronotype, even on weekends, to ensure consistent results.
7. If a sensor falls off or becomes faulty, contact your physician to schedule a repeat study.
8. Once the test is complete, return the sleep study device to your physician’s office for analysis.

By following these steps and taking care to ensure accurate results, you can conduct a sleep study at home and get the diagnosis you need to start treatment for sleep apnea or any sleep disorder you may have.

At home sleep study results

The American Academy of Sleep Medicine recommends that at-home sleep tests record at least airflow (pressure-based), pulse oximetry, heart rate, and the changes in the amount of air you breathe in and out while sleeping to ensure their capability. The data collected during an at-home sleep study includes oxygen saturation, airflow, and respiratory effort.

While at-home sleep studies have limitations, such as not monitoring brain activity and not diagnosing central or complex sleep apnea, they provide a powerful diagnostic tool for sleep disorders, mainly sleep apnea.

Sleep Study Result	Explanation
Apnea-Hypopnea Index (AHI)	A measure of the number of apneas (complete cessation of breathing) and hypopneas (partial reduction in airflow) per hour of sleep, indicating the severity of sleep apnea.
Oxygen Desaturation Levels	Information about the lowest oxygen saturation level recorded during the study, indicating significant drops in oxygen levels during sleep.
Respiratory Event Index	Indicates the frequency of respiratory events such as apneas, hypopneas, and respiratory effort-related arousals (RERAs), providing an assessment of overall respiratory disturbance during sleep.
Sleep Efficiency	Measures the percentage of time spent asleep compared to the total time spent in bed, reflecting sleep quality and efficiency.

These results help evaluate the presence and severity of sleep apnea and other sleep-related breathing disorders. If you would like to choose a much easier way you even can use your Apple Watch to detect sleep apnea.

The results are sent to your doctor for review, and in rare circumstances, your doctor may want you to come in for an in-lab study if the home test results are inconclusive.

These are my sleep apnea test results. The red signs below all signs an apnea!

FAQs

What do home sleep apnea tests measure?

Home sleep apnea tests measure various variables while a person sleeps to diagnose obstructive sleep apnea. The devices used in these tests include sensors attached to a person’s body, such as a nasal prong, fingertip probe, and belts around the chest and abdomen, which measure breathing effort, oxygen saturation levels, and heart rate. The number of sensors and types of measurements depend on the specific device, but the core data measured by most devices are AHI, pulse rate, SpO2, and total sleep time.

These tests are not capable of identifying patterns of sleep versus wake, but they provide doctors with the information needed to diagnose sleep-disordered breathing when interpreted by a sleep specialist.

What equipment is used for home sleep apnea tests?

Home sleep apnea tests utilize equipment that measures a person’s breathing, oxygen levels, and heart rate while they sleep. The test kit typically includes four sensors that the patient attaches to their body before going to bed. These include

1. a nasal prong to measure airflow,
2. a fingertip probe to measure oxygen saturation levels,
3. and two belts (one around the chest and one around the abdomen) to measure breathing.

Does Medicare cover home sleep apnea tests?

Medicare may cover a home sleep study if it is deemed medically necessary, but you will need a prescription from your doctor first. It is important to contact your insurance provider to confirm your coverage options before purchasing the test.

For example the SleepAgain Home Sleep Apnea Diagnosis includes a virtual consultation with a doctor who can write a prescription for the test if appropriate.

However, if your doctor recommends an in-lab sleep test, Medicare may cover that instead. It is important to be evaluated by a physician to determine the best test for your specific symptoms.

What is the difference between home sleep apnea tests and polysomnography?

While both tests measure factors such as airflow, blood oxygen levels, and heart rate, only polysomnography typically measures sleep by monitoring brain activity.

• Home tests are less invasive, less expensive, and involve fewer devices, but are less accurate and cannot collect as much information as in-lab tests. Home sleep apnea tests involve wearing a portable device that measures breathing and other health signs while sleeping at home.
• Polysomnography is recommended for diagnosing other sleep disorders besides sleep apnea. Polysomnography takes place in a sleep laboratory or clinic, and a technician monitors the person as they sleep.