image of brain waves from home sleep study

How to Diagnose Sleep Apnea at Home

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/ January 18, 2020
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If you think you might have sleep apnea, your doctor will likely recommend a sleep test. That's because sleep apnea can be life-threatening, as it's linked to serious health conditions, including an increased risk of heart disease, high blood pressure, diabetes, and stroke.

The best way to determine if you do have sleep apnea is through testing that measures your heart rate, blood oxygen level, and breathing patterns. Such tests used to be expensive, inconvenient affairs requiring you to spend the night in a lab. It's hard enough to sleep in an unfamiliar environment, much less with wires and electrodes strapped to your body! Plus, reviews of sleep labs frequently reported them as too cold, too warm, and even unclean. To top it off, the cost of these studies could run into the thousands of dollars.

Today, it's possible to do a home sleep test that can give your doctor much of the same information with less inconvenience and cost to you (a home sleep test usually costs around $300, and many insurance programs including Medicare cover them).

Here's what you need to know about home sleep tests and diagnosing sleep apnea.

How a home sleep test works

After picking up the home sleep test equipment from your doctor, you simply apply the sensors, attach the clip to your finger, put an airflow sensor under your nose, turn on the monitor, and go to sleep as you usually do. The home sleep test records your oxygen saturation, heart rate, airflow, movement in your chest and abdomen, sleep positions, and even the time you spend snoring.

The next day you simply return the device to your doctor. The data collected by the device is immediately available for interpretation. That means you will be able to know quickly what your course of action needs to be.

Related: How an at-home DNA test changed the way I sleep

The limits of home sleep tests and sleep trackers

The home sleep test won't necessarily provide the extensive results you get from a traditional sleep study in a lab. In addition to everything the home test records, a sleep lab study also measures brain waves, sleep time, and leg movements that would indicate Restless Legs Syndrome. You also won't have staff to make sure you properly connected everything. And it may not be right for you if you have coexisting health issues such as congestive heart failure or pulmonary disease.

That said, “Many of the portable devices currently available show a lot of promise with producing information that is in line with what we see in the lab," says Charlene Gamaldo, MD, medical director of Johns Hopkins Center for Sleep at Howard County General Hospital in Maryland. In fact, Johns Hopkins already uses several FDA-approved at-home devices for measuring sleep brain wave activity, assessing leg movements, and monitoring breathing.

These medical-grade devices aren't to be confused with Fitbits, Apple Watches, or other mass-market fitness trackers. Kelly Glazer Baron, PhD, of Rush University Medical School, and her colleagues report in the Journal of Clinical Medicine that some people who report sleep problems based on readings from their devices, apps, and gadgets refuse to believe objective test results in a sleep lab. “To the patients," they write, “sleep tracker data often feels more consistent with their experience of sleep than validated techniques, such as polysomnography and actigraphy."

While the devices can be useful adjuncts in keeping track of your sleep, they are far less reliable in producing meaningful sleep data. Baron and her fellow researchers point to “multiple validation studies that have demonstrated consumer-wearable sleep tracking devices are unable to accurately discriminate stages of sleep and have poor accuracy in detecting wake after sleep onset."

Nevertheless, smartphone and wearable tracking devices are likely to become more common in the sleep research field. “There are apps now that record a person snoring at home," says Gamaldo. “We hope to eventually correlate the information with actual features of sleep disorders, which could indicate the presence of conditions like sleep apnea."

The future of home sleep studies (beyond sleep apnea)

Joseph Krainin, MD, a fellow of the American Academy of Sleep Medicine and president and founder of Singular Sleep, an online sleep health company, foresees a future for sleep telemedicine that will almost entirely obviate the need for expensive, uncomfortable sleep lab testing. “The most common reason for referral to a sleep center is for sleep apnea evaluation," he says. “Testing for this disorder now can be done, for the majority of patients, at home."

Krainin says online video consultations with sleep physicians will become more common—and popular with patients. “Sleep telemedicine," he says, “and specifically comprehensive sleep telehealth clinics, offers an alternative pathway to sleep health care delivery that circumvents the problems" of high cost, inconvenience, and discomfort associated with traditional lab-based sleep testing.

For now, there's already been a technological revolution in sleep studies. As Gamaldo puts it, “Not too long ago, [sleep apnea] was a disorder we could only diagnose in the sleep lab."

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