At-Home Sleep Study

There are multiple ways to undergo a sleep study, including at a specialty sleep clinic and at home. Polysomnography is the term for a sleep study that takes place in a clinic and includes oversight from a technician throughout the night. But some people might prefer and have the option of taking a sleep study test at home.

Currently, at-home sleep studies can only be prescribed by a doctor when a person has symptoms of obstructive sleep apnea (OSA). OSA is a sleep-related breathing disorder that is characterized by loud and frequent snoring, periods of not breathing, and daytime sleepiness. In fact, these tests are often referred to as home sleep apnea tests.

Being able to take a sleep study in the comfort of one’s own home has led at-home sleep studies to become increasingly popular. However, while at-home sleep studies are generally considered effective, they do have some limitations. Learn more about at-home sleep studies and how they work.

People who experience snoring, choking, snorting and gasping during sleep, or excessive daytime sleepiness, may be referred to have an at-home sleep study by their doctor.

At-home sleep tests should only be taken under the guidance of a health care professional, and only if a person is experiencing symptoms of obstructive sleep apnea.

Compared to in-clinic polysomnography, at-home sleep studies offer several advantages.

• Comfort: Some people find it hard to fall asleep in a sleep laboratory or feel anxious about being tested in a clinical setting. Sleeping at home in their own bed may be a better option for getting a full night of sleep.
• Convenience: Sleep clinics tend to be located in more densely populated areas, which may require people who live farther away to travel a greater distance for testing. At-home tests are usually made available through a person’s local health care provider or can be delivered to their home.
• Expense: People may need to consider whether their health insurance covers the cost of testing or if they need to meet a deductible or pay out of pocket. At-home testing is less costly than in-clinic testing, potentially making it more accessible for many people.

Home sleep studies are not appropriate for evaluating other sleep disorders like insomnia, narcolepsy, or restless legs syndrome. They are not appropriate for those who have coexisting medical conditions such as a heart disease or neuromuscular disorder. As a result, it is important to share all of your symptoms and sleep problems with your doctor when considering a home sleep study.

Your at-home sleep study includes a sleep monitoring device and wearable equipment. Your doctor or another member of your health care team will explain how to set up the device and what each piece of equipment does.

During an at-home sleep study, you may need to wear one or more monitoring devices:

• Electrodes: Electrodes are small sensors that stick to the skin in order to record electrical activity in the body. When placed around the chest, they can detect how much effort it’s taking to breathe.
• Nasal cannula pressure transducer: A nasal cannula pressure transducer is a small plastic device attached to a tube that fits in the nose to monitor airflow.
• Pulse oximeter: A pulse oximeter is usually worn on the tip of the finger to detect how much oxygen is in the blood.

Only a doctor can prescribe and order an at-home sleep study for you. In the United States, the FDA classifies products used for at-home sleep studies as medical devices. Federal regulations help to ensure that at-home sleep tests are effective and safe for people to use.

At-home sleep studies are intended to be convenient and relatively easy for a person to set up and use. There are several steps involved in preparing for and undergoing a sleep study.

1. Get a prescription: At-home sleep studies should only be performed once a doctor has deemed them appropriate based on your symptoms. They can help decide which type of sleep study is best for you and explain what to expect.
2. Receive the device: The machine and equipment for a home sleep study can be sent to your home or picked up at the doctors office.
3. Follow instructions: Read over all of the instructions that come with your sleep study. Sometimes videos demonstrate how to wear the equipment. If you have any questions, check to see if there is a manufacturer’s helpline available or call your doctor’s office.
4. Go to sleep: Since you’re at home, prepare for bed as you usually do, following your normal night time routine. Place the equipment on your body as indicated, and then you can go to sleep.
5. Take off and return equipment: In the morning, you will not immediately know the results of the sleep study. All you have to do is take off the equipment, turn off the device, and return it by mail or to your doctor’s office.
6. Follow up with the doctor: After your at-home sleep study, your doctor will schedule an appointment to discuss your results and help you plan the next steps for care.

In-clinic polysomnography is considered the standard assessment for diagnosis for OSA. This is because polysomnography includes additional measurements compared with home sleep studies and is less likely to miss a sleep apnea diagnosis in someone who has the condition.

Polysomnography also involves technicians who monitor the device and are available to provide support throughout the night. Technicians can help ensure the equipment and devices are working properly throughout the test, so there is a smaller chance of receiving inconclusive results.

However, at-home sleep studies are becoming more commonly recommended by doctors for people with symptoms of moderate to severe OSA. Although home sleep studies collect less data, they are generally easier to administer, making them more convenient and accessible.

Another reason at-home testing is becoming more widely used is likely due to major U.S. insurance payers, including Medicare and Medicaid, accepting the diagnostic results from these tests when determining insurance coverage for treatment of OSA.

Doctors may consider accessibility of polysomnography centers, financial cost, and your medical history when determining whether an in-clinic or home sleep study is right for you.

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Sleep studies can provide you and your doctor with detailed information about your sleep and how your body functions while you sleep. The results of a home sleep study depend upon the type of device and equipment that were used. They may include information about:

• Respiratory effort and airflow
• Heart rate
• Blood oxygen levels
• Snoring
• Body position and movement

Home sleep studies generally use a computer to automatically estimate how many breathing interruptions a person has while they are being monitored with the equipment. Your doctor will review and interpret these results.

If an at-home sleep study shows that you have an abnormal number of breathing-related events, which are usually represented by the apnea-hypopnea index (AHI), it may indicate that you have obstructive sleep apnea.

Sometimes, an at-home sleep apnea test will produce inconclusive results or indicate a negative result when you have symptoms of sleep apnea. If you have signs, symptoms, or risk factors that indicate you may have OSA, your doctor may recommend that you follow the home sleep study with in-clinic polysomnography.

An at-home sleep study can be a convenient way to find out whether you have obstructive sleep apnea without having to visit a clinic overnight. But since a home sleep study involves testing on your own, it’s important to make sure you understand the test and how to prepare for it in order to obtain the most accurate results possible.

• Ask for help: If you’re going to take a home sleep study, be sure to ask your doctor questions about the process. They can give you thorough instructions on how to use the equipment and conduct the study.
• Consider your habits: Practice good sleep hygiene and avoid drinking alcohol and caffeine in the afternoon or evening before you take your test since alcohol can worsen sleep apnea. Studies suggest that even eating meals late at night can affect the severity of sleep apnea.
• Cut out naps: You should also avoid taking a nap on the day you take your sleep study to help yourself fall asleep at night.
• Avoid skin and hair care products: Beauty products like lotions, hair gels, and makeup can affect the way electrodes work. Avoid using or rubbing these products on your skin and hair before you take your sleep study.

About The Author

Afy Okoye

Staff Writer, Sleep Health

Afy is a writer and creative strategist in San Francisco with a master’s degree in international health policy from the London School of Economics. She has written for VeryWell Health, BlackDoctor.org, and Paste magazine and edited peer-reviewed journal manuscripts for Elsevier. Afy says her work with The Sleep Doctor is anything but “sleepy.” She enjoys the opportunity to learn new information and share knowledge that gives people the power to make better choices. Afy also likes to read non-fiction, do creative writing, and travel solo.

• Position: Side Sleeper
• Temperature: Hot Sleeper
• Chronotype: Bear

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