Home Sleep Testing
Home Sleep Testing
Home Sleep Testing has become more prominent as an alternative to in-center, attended sleep studies. For the right patient, Home Sleep Testing can be a great beginning to the evaluation process for sleep rated breathing disorders, such as obstructive sleep apnea. Although having an unattended sleep study at home may be more economical and convenient, there are reasons that Home Sleep Testing may not be appropriate or suggested. Home Sleep Testing is specifically designed to look for obstructive sleep apnea and would not be helpful when trying to evaluate for other, more complex sleep disordered breathing such as central sleep apnea and Cheyne – Stokes respiration. It would also not help in the evaluation of insomnia related sleep disorders, movement disorders, parasomnia disorders, and circadian rhythm sleep disorders. It is also not indicated for the pediatric patients.
In general, the Home Sleep Test could be good for patients that are in a high risk group for obstructive sleep apnea, which would include a generally healthy person that are known to snore, have witness apneas or wake up gasping for air and finds themselves falling asleep at inappropriate times during the day.
The Home Sleep test may not apply to patients that may have moderate to severe pulmonary disease, a neuromuscular disease, history of stroke or epilepsy, severe congestive heart failure, and are super-obese with BMI >45. If you have concerns for Periodic Limb Movement Disorder, Parasomnias like nightmares and night terrors, Narcolepsy with and without Cataplexy and central sleep apnea. It would also not be appropriate for those patient with a low pre-test probability of obstructive sleep apnea because your BMI <30, observed to have a normal airway, no report of snoring, and normal neck size, which is <17” for men and <16” for women.
If you do have a Home Sleep Test performed, many times the results return as technically inadequate or inconclusive, which would require an in-center, attended sleep study to confirm the results and if it does indicate the presence of obstructive sleep apnea, the use of an AutoPAP may be recommended as an initial treatment option but if chief complaints are not resolved after using the device at home for 30+ days then a titration study performed in the sleep center may be required.