All You Need to Know About Sleep Apnea Tests from Home

Ever wondered if you're snoring more than usual, or if you wake up feeling groggy despite getting enough sleep?

It might be time to consider a sleep apnea test. While traditional in-lab sleep studies have been the go-to, the rise of at-home sleep apnea tests offers a more convenient and accessible option.

But is it right for you? Learn more about sleep apnea testing and explore the pros and cons of doing it from the comfort of your own home.

What is an in-home sleep apnea test?

The under-diagnosis of OSA has led to increasing complications and morbidity among affected populations. Luckily, home sleep apnea tests (HSATs) have become more popular and accessible since their approval by the US Centers for Medicare & Medicaid Services in 2007. In fact, around 60 to 70 percent of suspected cases of sleep apnea are now diagnosed with home tests.

A sleep apnea test, or polysomnography (PSG), is a diagnostic procedure used to identify and assess obstructive sleep apnea or OSA. This condition involves periods of disrupted breathing in the middle of sleep, usually because of the collapse of the airway.

In-home sleep apnea test vs laboratory test

Deciding between an in-lab or in-home sleep study can feel like a toss-up.

In-lab polysomnography is like getting a VIP experience since it offers comprehensive data collection and accurate diagnoses for various sleep disorders. But it's also like a luxury hotel stay—high-priced (as much as $3000) and requires a bit more planning.

In-home polysomnography is more like a cozy night in. It's affordable, flexible, and perfect for those who can't leave home. All you need is a prescription from your doctor, and then you’re off to your house with a portable sleep monitoring device. While an at-home test is great for diagnosing obstructive sleep apnea, it's not as versatile as its in-lab counterpart. It's like that reliable friend who can help you with one specific issue but might offer limited help in other areas.

So, which test for sleep apnea is the best for you?

If you have a complex medical history or suspect you might have a sleep disorder other than OSA, an in-lab study might be the best option. But if you're pretty sure you have OSA and prefer the comfort and convenience of your own home, an in-home test could be the way to go.

How does a home sleep apnea test work?

A home sleep apnea test involves using a portable device to monitor your breathing (but not your sleep quality) while you rest in your own bed. The device may include a combination of the following:

A nasal cannula, chinstrap, or nasal breathing sensor - These devices measure airflow through your nose and mouth. Snoring is also usually measured with the nasal breathing sensor. However, in some cases, a microphone might be used for more precise sound detection. Additionally, a sound sensor placed on the neck can record both sound and pressure.

Data collection device - Besides nasal breathing sensors, others will be placed on your chest and abdomen to measure their rise and fall while you breathe. All sensors are connected to a central device that collects the data. This device might have buttons you press to start and stop recording, and lights to show you when it’s working.

A pulse oximeter - This device is placed over a fingertip to measure blood oxygen levels.

Effort belt or patch- An effort belt, which is less common in home tests, measures chest movement to help distinguish between obstructive sleep apnea and central sleep apnea (CSA). OSA involves effort to breathe, while CSA is caused by a lack of brain signals.  Some home sleep apnea test devices actually utilize a patch with an optical sensor that is applied on your chest and/or abdomen which allows for measurement of your effort to breathe.

While sleeping, the portable device records data about your breathing, heart rate, and sleep stages. Once the test is complete, a sleep specialist will analyze the results and share them with your doctor. They will then analyze the information to determine if you suffer from sleep apnea. Afterward, a sleep specialist might recommend an appropriate treatment such as a Bi-level Positive Airway Pressure (BiPAP) machine. If your symptoms continue, your doctor might suggest a more in-depth sleep study at a clinic.

Popular Home Sleep Apnea Testing Kits

Night Owl and Wesper are two very popular at-home sleep apnea tests in the market today.

Night Owl

Night Owl is a single-use device designed for a one-time assessment. However, it can be reused up to 7 nights for multi-sleep testing. It's particularly suitable for individuals who suspect they have mild to moderate sleep apnea and want a quick and easy evaluation. The device is comfortable to wear and provides a basic overview of sleep quality, including blood oxygen levels and heart rate. However, it may not be as sensitive as in-lab studies for detecting more severe cases of sleep apnea.

Wesper

Wesper offers a more comprehensive and ongoing monitoring solution. With its unique design, it is quite accurate with the detection of obstructive and central sleep apnea at home.  Furthermore, the device allows for long-term monitoring which can be very helpful to monitor your progress to treatment over time.  The device's microphone feature can provide valuable insights into snoring habits and other sleep disturbances. However, it's important to note that the microphone's accuracy can be influenced by environmental noise and the snoring of others in the same room.

Both the Night Owl and Wesper test kits are convenient to use. You only need to pair your device with their sensors and start recording in the app as you go to bed. When you wake up, you can stop recording and the app will upload your data. Your doctor will receive a notification of the data upload so they may review it and make a report. Last but not least, you may schedule a consultation to discuss the results and potential treatment options.

Pros of a home sleep apnea test

Convenience

Home sleep tests offer the comfort and convenience of conducting the test in your own sleep environment. Your home is likely to be more conducive to sleep than a clinical setting, with familiar sounds, smells, and temperature. Plus, home tests minimize the disruption to your daily routine, as you don't need to travel to a sleep clinic.

In addition, home sleep apnea tests have been deemed helpful for stroke patients who need to stay in the hospital for rehabilitation. HSAT recordings were usable in 92% of cases, and there was a positive correlation between the results of the home test and the laboratory-based polysomnography. HSAT testing for stroke patients is a quick and convenient way to help them access treatments sooner rather than later.

Accessibility

They are often less expensive and easier to schedule than in-laboratory tests. An at-home sleep apnea test often costs less than $600, which is around 5x cheaper than an in-lab test.

Reduced anxiety

Sleeping in your familiar surroundings can help alleviate anxiety associated with the testing process. This can lead to more accurate and reliable data, as your sleep patterns are less likely to be disrupted by unfamiliar surroundings.

Cons of a home sleep apnea test

Limited monitoring

While home tests provide valuable information, they may not capture all the nuances of sleep apnea that can be detected in a laboratory setting. Specifically, even if an at-home test returns positive results, they quite often underestimate the underlying sleep apnea burden. Hence, it is best to augment your at-home sleep apnea test with healthcare professionals’ advice.

Potential for errors

Home tests rely on accurate device placement and usage, which can introduce potential for errors in data collection. Relevant to this, a 2022 study by Zancanella et al. discovered “no difference in sleep efficiency” between individuals who took sleep tests at home and in a laboratory. In other words, the researchers found no difference in how well people slept, how long they slept, or how quickly they fell asleep between the two groups.

However, there were some differences in specific sleep stages when monitoring was done at home since the patients woke up more often during the night and took longer to fall asleep after waking up. But these differences were likely due to technical issues with the home monitoring equipment.

Additionally, the potential for error due to limited data is a risk not only for home-based tests but also for laboratories. Fortunately, limitations in data collection are currently solved by performing multiple nights of home sleep testing in a row to produce greater data and a more accurate assessment.

May not be suitable for all patients

Certain individuals, such as those with complex medical conditions or a history of sleepwalking, may require a more comprehensive in-laboratory test.

Note that if you suspect you may have sleep apnea, it's best to consult with a healthcare professional to discuss the most appropriate testing option for your specific needs.

Factors to Consider When Choosing a Home Sleep Apnea Test

Device features

Different home sleep apnea devices may offer varying features and capabilities. Consider factors such as the ease of use, battery life, and data recording accuracy.

Healthcare provider recommendations

Consult with your doctor or a sleep specialist to get recommendations based on your personal needs and medical history.

What to Expect During a Home Sleep Apnea Test

Preparation

You will likely be provided with instructions on how to prepare for the test, including avoiding caffeine and alcohol before bed.

Test night

On the night of the test, set up the device as instructed and follow your usual bedtime routine. You may be asked to wear a pulse oximeter on your finger to monitor blood oxygen levels.

Data analysis

After the test, you are expected to return the sleep monitoring device to the clinic unless it is a disposable one. Your healthcare provider will retrieve and analyze the recorded data to determine if you have sleep apnea.

Follow-up

If the test indicates that you have sleep apnea, your healthcare provider will discuss treatment options, which may include BiPAP or continuous positive airway pressure (CPAP) therapy, oral appliances, or lifestyle changes.

While home sleep apnea tests are convenient, they may not be suitable for everyone. In some cases, an in-laboratory sleep study may be necessary to provide a more comprehensive diagnosis.

Take the First Step to More Restful Sleep

Choosing between an in-lab or in-home sleep apnea test depends on your individual needs and circumstances. If you're looking for a more convenient, affordable, and less invasive option, an at-home test might be the perfect fit.

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However, it's essential to consult with sleep specialists like the pros at nightly.health to determine the best approach based on your specific symptoms and medical background.

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A good night's sleep is an essential ingredient for your overall health and well-being, so don't hesitate to take the first step towards a more restful night!

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Can’t commit to home testing just yet? We have a free online sleep assessment just for you!

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