Trending now: Home sleep tests

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In the US context of this dated newsletter: Want to find out if the snoring, gasping, or choking sounds you're making during sleep are actually signs of obstructive sleep apnea? Until recently, you would have had to go to a sleep lab, get hooked up to dozens of sensors, and spend the night. Now, thanks to the miniaturization of sophisticated technology, you can conduct a basic sleep test in your own bed. "Home sleep tests are often the preferred approach to detect sleep apnea, not just by doctors, but also by insurance companies. Many are no longer covering in-lab studies, which cost thousands of dollars. A home sleep test costs a few hundred dollars, and it's usually covered," says a sleep specialist at Harvard-affiliated Brigham and Women's Hospital. However, she cautions that you can't always rely on results from a home test.

What's involved?

You need a prescription for a home sleep test. You can talk to your primary care physician or a sleep specialist about it. Or you can order a home sleep test online from any number of companies. You visit a company's website, purchase the test, and talk to a company-affiliated doctor via telemedicine. The doctor can prescribe the test if it's right for you.

the sleep specialist has reservations about arranging a test online. "You won't know if it's the best-quality sleep test or the best interpretation of the results. A lot of those companies just send a standardized blurb about the results," she says.

Taking the test

Either you will pick up your test from your doctor's office or the test will be delivered to you. It involves wearing a few small sensors overnight, typically

• a nasal cannula, a loop of thin tubing worn under the nose to measure your breathing patterns
• a pulse oximeter, a small gadget placed on the finger to measure oxygen levels in your blood
• a chest strap, an adjustable belt that measures the effort or movement your body is making to breathe.
• Each of those sensors plugs into a small data monitor, which is worn on the chest strap.

A newer type of home sleep test has even less equipment. The data recorder is worn on the wrist, like a watch. It connects to a pulse oximeter and a small chest sensor. The chest sensor measures breathing effort and snoring sounds.

Test results

While it's not as detailed or as accurate as an in-lab sleep study, a high-quality home sleep test yields fairly reliable results. "You have an 80% chance that the test will be right," the sleep specialist says. "But we compare the results with your symptoms to help make sure the results are accurate and to determine the best treatment options."

If the test results don't match your symptoms - for example, if you have sleep apnea symptoms and a negative test result - your doctor will have to investigate further. "We'll look at the context of the results and the circumstances of the test. It could be that you had nasal congestion on the night of the test, you were breathing through your mouth, and the nasal sensor didn't pick that up," the sleep specialist says. "If we have strong suspicions that you have sleep apnea, we'll need to schedule an in-lab study."

What is obstructive sleep apnea?

Obstructive sleep apnea is a condition marked by 10- to 30-second pauses in breathing during sleep. Those pauses are called apneas and can occur hundreds of times per night. The breathing disruptions occur when the airway in your nose or throat becomes partially or completely blocked by large tonsils, a large tongue, or too much tissue in the airway. Untreated obstructive sleep apnea increases the risk for high blood pressure, heart disease, stroke, daytime sleepiness, and car accidents.

Should you consider a home test?

The tests aren't for everyone. People with a serious chronic condition, such as heart failure or a breathing disorder, may need additional data from an in-lab study to help determine treatment. For people who don't have serious chronic conditions, a home sleep test can be a game changer.

"If you have a straightforward case, it's the best way to go," the sleep specialist says. "It's cost-effective, and it's more comfortable than an in-lab study. And since you are doing the test at home, it is more likely to capture your natural sleep habits."

This is the supplied newsletter’s dated educational content, not individual medical advice. The quoted 80% figure is the source specialist estimate, not a guarantee for every test. Costs and insurance coverage describe the US source context, not current Australian eligibility. A clinician should choose and interpret the test.

Earlier published guidance

Millions of people snore, and snoring can be a sign of obstructive sleep apnea - repeated pauses in breathing during sleep that raise the risk of heart disease, stroke, diabetes, and daytime fatigue.

Traditionally, diagnosing sleep apnea meant an overnight stay in a sleep lab, wired to monitors. That is changing: home sleep tests now let many people check for apnea in their own beds.

Home tests typically use a small device worn on the chest, wrist, or finger, with sensors that track breathing patterns, oxygen levels, heart rate, and sometimes body position and movement overnight.

The results go to a sleep specialist, who reviews the data and decides whether the pattern matches obstructive sleep apnea and how severe it is.

Home testing works best for people with a strong likelihood of moderate to severe sleep apnea and no other major health problems. It is less reliable for people with heart failure, lung disease, or other sleep disorders, where an in-lab study may still be needed.

A home test cannot capture everything a lab study does. It generally cannot tell how long you actually slept, which sleep stages you reached, or whether other disorders - such as periodic limb movements - are at play.

If your home test is negative but symptoms like loud snoring, witnessed breathing pauses, or heavy daytime sleepiness continue, talk to your doctor about an in-lab study, which records far more information.

Treatment for confirmed sleep apnea usually starts with continuous positive airway pressure (CPAP), a mask that keeps the airway open during sleep. Weight loss, side-sleeping, oral appliances, and in some cases surgery are other options.

If loud snoring, gasping awakenings, or unrefreshing sleep sound familiar, ask your doctor whether a home sleep test makes sense for you.