Home Sleep Tests Versus a Lab Sleep Study

More and more sleep centers around the nation are offering patients at-home sleep test kits to discover more about their sleep problems. These home sleep tests are generally only used to diagnose or rule out obstructive sleep apnea. But can these tests be trusted?

A Few Areas of Concern

An Incomplete Measurement: A home sleep test does not measure everything that a lab polysomnography (PSG) can. Lab testing can accurately monitor the brain, blood oxygen levels, lungs, limb movements, heart rate and body position. A home test does not measure the full Respiratory Disturbance Index (RDI), meaning that subtle breathing irregularities are missed. Furthermore, it has been found that mild to moderate sleep disorders are sometimes missed in home sleep testing.

Patient Errors: Home sleep tests require a patient to correctly place equipment on themselves. This equipment can be moved during sleep, or be placed incorrectly, which leads to faulty results or no results, meaning serious disorders can be missed.

Furthermore, patients often error when estimating when they went to sleep, and how long they slept in total. In a lab, professionals monitoring the patient can ensure the correct placement of equipment, and the correct measurement of important variables. A Home sleep test does not tell whether there was sleep or what stages of sleep did not occur which are important to assess.

CPAP Usage: When you wake up in the middle of the night, sometimes it’s because of a glitch in the nervous system, meaning the brain forgets to breathe. It can also come from a mechanical issue in your breathing, such as when the soft structures in your throat close the airway. This decreases how much oxygen your body is getting. Continuous positive airway pressure (CPAP) therapy, which involves a machine that increases air pressure in your throat to keep airways from collapsing, is an effective treatment.

Sometimes it is hard for patients to be motivated to use CPAP. In our lab studies, patients are more engaged as we review raw data of breathing abnormalities, and this motivates them to use CPAP, significantly improving their symptoms.

For some people especially it is recommended that in-lab testing is performed rather than at home. If you have congestive heart failure, a pulmonary disease or a neuromuscular disease, have a sleep test done in a lab. Also, if you have other diagnosed sleep disorders, such as narcolepsy, insomnia, periodic limb movement or less known variant of sleep apnea called Upper airway resistance syndrome, have a lab test rather than a home test.

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