What Is A Home Sleep Test?
At least 25 million American adults struggle with obstructive sleep apnea (OSA), according to the National Sleep Awareness Project. Sleep technologists, like you, use sleep studies to help diagnose sleep apnea, primarily OSA. Some patients, in conjuction with their physician, may now choose a home sleep apnea test (HSAT) instead of an in-lab sleep study.
What is a Home Sleep Test?
A home sleep apnea test is just as it sounds: a sleep test your patients can take from their own home to determine if they have sleep apnea. Your patient may come into the sleep center to pick up equipment for their home sleep test. You'll demonstrate to them how to perform the test, including how to use the machine and equipment properly. The patient goes home and performs the test. The data obtained is stored on the equipment and is uploaded at the sleep center the following day.
Home sleep tests are designed to provide your patients with a convenient way to get the test done while allowing you to collect important information on how they sleep and make a diagnosis of OSA.
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Who Participates in a Home Sleep Test?
Home sleep tests normally attract patients who have no insurance or have a high deductible on their insurance plans since they're not as expensive as in-lab studies. Home sleep studies are also good for homebound patients, the elderly, those with a chronic illness, and those who have a hard time taking time out of their busy schedules.
What is the Process and What Happens During a Home Sleep Test?
On the day your patient plans on taking the test, they should:
- Avoid napping.
- Follow their normal routine as much as they can.
- Avoid caffeine after they eat lunch.
They should let you know if they're taking regular medication, since the physician may want to have them discontinue it temporarily, depending on what it is.
Before the patient's home sleep test, they'll come by sleep clinic to pick up the equipment. They can also opt to have it delivered to their home. Provide them with instructions on how to use the home test and equipment, and be ready for any questions they may have on things they don't understand.
Let them know they can go to bed at their regular time. When they're ready to go to sleep, they'll attach the sensors to their body like you instructed. They may need to press a button on the device when they're getting into bed, and most patients are asked to keep a sleep log.
The sensors typically include a sensor that slips over the patient's index finger to monitor their oxygen levels and heart rate, and another set of sensors that monitors their breathing patterns. Your patient straps these sensors on their chest and places a small tube similar to an oxygen cannula in their nostrils to measure airflow through their nose.
When your patient wakes up the following morning, they'll remove the sensors. They either return the device back through the mail or bring it to the sleep clinic.
Benefits of a Home Sleep Test
Home tests are convenient, cost-effective, and comfortable. Other benefits of a home sleep test include:
- Your patient can administer their own home sleep test and can spend the night in their own home in their own bed in familiar surroundings. This reduces first night effect.
- A home sleep test may be the only option for your patients who are elderly, homebound, or have a chronic illness and need specialized care provided by a family member or home nurse.
- A home sleep apnea test may also be beneficial for your patients who are having a hard time arranging time out of their busy schedules to get to an overnight in-lab study or those who can't afford expensive transportation costs.
- The average cost of a home sleep study is a mere fraction of what an in-lab study would cost, and in the diagnosis of OSA, typically yields similar results.
Home Sleep Test vs. In-Lab Sleep Studies
Sleep technologists like you perform sleep studies to assist the physician to identify and diagnose sleep disorders. These studies can be performed either in-lab or in the patient's home. There are advantages and disadvantages of both, however, in-lab studies are shown to be more controlled and effective than home sleep tests.
Home Sleep Tests
As mentioned, home sleep tests are exactly how they sound. The patient administers their own home sleep test in the comfort of their own home and own bed. A home sleep test is used mainly for diagnosing your patient with OSA. As a sleep technologist, you'll likely only perform a home sleep test if the prescribing physician believes your patient's OSA is moderate or severe. Home sleep tests often under-diagnose sleep breathing conditions and might falsely conclude your patient doesn't have sleep apnea at all if their OSA is mild to low-moderate in severity.
A home sleep test is not the right option for patients who may have other sleep disorders, comorbidities, or other medical problems like congestive heart failure, chronic obstructive pulmonary disease, or neuromuscular disease.
Since home tests are only used to diagnose breathing disorders, there is less equipment your patient has to deal with. A home sleep test comes with devices that your patient can easily apply themselves and includes:
- A belt that measures respiratory effort and is placed around the upper chest
- A small nasal cannula that measures airflow
- A finger clip that measures blood oxygen saturation
During their home sleep test, your patient needs to ensure the equipment is functioning correctly and is on properly. An issue with a home sleep test is that if a piece of equipment disconnects while your patient is sleeping during the night and they don't wake up, it won't provide enough data to ensure a complete study. Therefore, the patient will have to retake the test.
Since a home sleep test only measures and doesn't diagnose, your patient will still have to make an appointment with the physician who will interpret the data and determine a diagnosis.
In-Lab Sleep Study
During an in-lab overnight sleep study, you'll use a polysomnogram (PSG) to test for a whole range of sleep disorders and assist the physician to make a diagnosis. Some sleep disorders you might use a polysomnogram to test for include:
- Periodic limb movement disorders (PLMD)
- Breathing disorders
- Circadian rhythm disorders
There are many monitoring devices included with a PSG that assist with accurate diagnosis of various sleep disorders. There are electrodes that measure eye movement, chin muscle activity, brain activity, and muscle movement of the limbs, airflow sensors and belts that measure breathing effort, and EKG monitors that measure heart rhythm and rate.
A home sleep test, however, can only test for breathing disorders like OSA.
In-lab studies aren't as uncomfortable as patients would think. Sleep centers often furnish the rooms with homey decor and furniture, high-quality bedding, and minimal hospital equipment making the room more relaxing to the patient and helping them feel more at home.
During an in-lab sleep study, you'll use more sensors than a home test to collect important and accurate data. You'll monitor the patient's progress all night long to make sure all equipment is functioning properly and ensure your patient is following protocol during the entire study.
In-lab studies can measure brainwave activity, unlike home sleep tests. This means, whether your patient lies awake in bed or is sleeping, there's no difference in the home sleep test that's noticeable.
In-lab results are usually faster to get back to your patient. You score the study right there in the sleep clinic which often makes it available for review by a sleep physician the following day. Home sleep test results can take a few days since you have to wait for the equipment to get back to the sleep clinic and upload the data for scoring. You'll then have to score the study and send the sleep physician the data for interpretation. This can take some extra time.
- Home sleep tests allow your patient to take a sleep study test at home.
- Home sleep tests are sometimes used to test patients who are homebound, elderly, or can't afford the cost of an in-lab sleep study.
- Patients self-administer home sleep tests.
- Patients are instructed how to perform home sleep tests.
- Home sleep tests are mainly used to diagnose patients with a strong suspicion of OSA.
Want to learn more? Grab this must-have guide, Sleep Technology Terms and Definitions, to read about the latest explanations of key terms that are used in the routine practice of sleep technology to advance your career as a sleep technologist.