Around 5% to 15% of people have obstructive sleep apnea (OSA), a sleep-related breathing disorder that causes temporary pauses in breathing during sleep. However, researchers estimate as many as 90% of cases go undiagnosed.
If you think you may have OSA, your first step is to talk to a doctor about your symptoms. They may recommend two options for diagnosis: an overnight sleep study in a lab, or an at-home sleep apnea test.
What Is an At-Home Sleep Apnea Test?
A home sleep apnea test is a test that can help diagnose obstructive sleep apnea at home. The device itself is a portable breathing monitor you wear overnight. As you sleep, the device monitors your breathing and oxygen levels to detect and measure pauses in breathing, which are known as apneas. The test calculates an OSA severity score by calculating the average number of lapses in breathing per hour in bed.
Polysomnography, an overnight sleep study performed in a lab, provides the most accurate diagnosis for obstructive sleep apnea. However, this type of test can be more expensive, and people in certain areas may face long waitlists or lack easy access to a sleep center. At-home sleep apnea tests are designed to make testing more accessible and help ensure people get the treatment they need.
At-home sleep apnea tests may be appropriate for diagnosing OSA in some people, as long as a qualified sleep specialist interprets the results. However, polysomnography is the better option for people who are suspected of having another medical condition or sleep disorder in addition to OSA.
How At-Home Sleep Apnea Tests Work
The process for at-home sleep apnea testing involves receiving a prescription from your doctor, conducting the test at home, and then sending your results to be interpreted by a sleep specialist.
Obtain a Prescription
You should have a prescription from a doctor to obtain the home sleep apnea test. First, you need to schedule an appointment with your primary care physician or a sleep specialist, who will ask you about your symptoms and pre-screen you for obstructive sleep apnea. Then, based on their assessment, they can order the prescription for you and explain how to use the testing kit. You can pick up the test in person or have it delivered to your home.
Take the Test
Depending on the type of sleep test, you may need to use several different sensors.
Sleep tests fall into different categories depending on how accurately they measure different sleep metrics. Home sleep apnea tests are generally classed as level III or level IV. Level III tests use a greater number of sensors to capture relevant information such as blood oxygen levels, airflow, snoring, body position, or heart rate. There may be variations between tests, as researchers are still developing new testing kits.
The American Academy of Sleep Medicine recommends that home sleep tests include measurements of airflow, blood oxygen levels, and breathing effort, at the very least. Common sensors for a type III device include an acoustic sensor to calculate airflow, an effort belt that wraps around the chest to track your breathing patterns, and a small clip called an oximeter that you wear on your finger to track your blood oxygen levels.
To ensure a more accurate reading, avoid napping, caffeine, alcohol, and late or heavy meals on the day of the test. Some experts believe it is better to sleep with the portable test equipment for one to three nights to gather enough data. For many people, sleep apnea is worse when back sleeping as opposed to side sleeping. Collecting data over multiple nights and informing your doctor of your habitual sleep positions might help give a more accurate view of your symptoms.
Review the Results With Your Doctor
After you have finished taking the sleep apnea test at home, a sleep medicine specialist must interpret the data, decide whether your symptoms qualify for an OSA diagnosis, and work with you to establish the best treatment plan for your needs.
Benefits of At-Home Sleep Apnea Tests
The key benefits of an at-home sleep apnea test compared to traditional polysomnography are shorter wait times and increased convenience, affordability, and comfort.
The alternative to an at-home sleep apnea test is an overnight sleep study conducted in a lab. Sleep centers aim to make these comfortable by providing a nice bedroom. However, you are still sleeping somewhere that feels unfamiliar, and there are technicians monitoring you while you sleep. For people who find that uncomfortable, a sleep apnea test at home may be preferable.
At-home sleep apnea tests are generally more convenient than a polysomnogram. Instead of finding a sleep clinic, scheduling the overnight exam, and driving to and from the clinic, you can pick up the sleep apnea test at your local pharmacy or doctor’s office and administer the test yourself at home.
For the sleeper, at-home sleep apnea testing is generally more affordable than a polysomnogram and is often covered by insurance.
Shorter Wait Times
Whereas sleep clinics often have long waitlists, at-home sleep apnea tests can usually be administered more quickly as they do not require people to come into the lab. The sooner you receive a diagnosis of OSA, the sooner you can start treatment and begin to find relief from your symptoms.
Things to Consider About At-Home Sleep Apnea Tests
Taking a sleep apnea test at home offers many benefits, but there are some drawbacks to consider.
When you take a sleep apnea test at home, the machine monitors your breathing once you turn it on. Instead of dividing the total number of respiratory events by your total sleep time, they are divided by the total amount of time you spend in bed, which tends to be longer. As a result, at-home tests can underestimate the severity of sleep apnea by calculating an hourly rate that appears lower than it really is. By contrast, polysomnography is able to record when you are sleeping and when you are awake for a more accurate score.
Possibility of Technological Malfunctions
Since they are not overseen by a qualified health professional, home sleep apnea tests are more vulnerable to errors. For example, it is possible for sensors to fall off or become dislodged while you are sleeping, which you may not realize until you wake up. During a lab-based polysomnogram, on the other hand, a technician can reset the sensors and ensure everything is working as expected.
Limited in Scope
Home sleep apnea tests only monitor your breathing and oxygen levels. Overnight sleep studies monitor significantly more vitals related to sleep, including your brain waves and leg and eye movements. Because an at-home sleep apnea test does not capture information about total sleep time, nighttime awakenings, or sleep stages, it cannot test for non-breathing-related sleep disorders, such as narcolepsy.
The American Academy of Sleep Medicine only recommends using at-home sleep tests to diagnose obstructive sleep apnea. They are not currently indicated for central sleep apnea, a rarer form of sleep apnea where the pauses in breathing are caused not by a collapse of the airways, but by the brain’s failure to send signals to breathe.
If the results of your at-home sleep test are inconclusive, or if you have additional symptoms that warrant a more comprehensive evaluation, your doctor may recommend an additional polysomnogram.
How to Decide If an At-Home Sleep Apnea Test Is Right for You
At-home sleep apnea tests are currently prescribed to healthy adults with symptoms that suggest moderate or severe OSA, and not another sleep disorder. If that describes you, and you would prefer to take your test at home instead of in a sleep center, an at-home sleep apnea test may be the right choice for you.
If, on the other hand, you have an underlying health condition or sleep disorder, the increased accuracy and comprehensiveness offered by an overnight sleep study may be the better choice.
It is best to talk to your doctor about your options. They can help you make this decision based on your symptoms and personal medical history.
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