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Sleep Apnea Test and Diagnosis

The greatest technology advances in sleep have been made in the diagnostic technology for the home solution, focusing on size, comfort, ease to use and accuracy of sleep test results.

Sleep facilities' technology for conducting diagnostic testing procedures has been relatively stagnant for several years. Therapeutic device technology (i.e. CPAP) has been improved over time to facilitate ease of use and patient comfort. The greatest technology advances in sleep have been made in the diagnostic technology for the home solution. Home solutions technology focused on size, comfort and ease of use.

There are two major sleep study tests that are widely accepted:
  • Home Sleep Test

    This test is conducted at the home of the patient. This test is specifically designed to assist in the diagnosis of sleep disordered breathing, specifically Sleep Apnea. The test is convenient for the patient and many experts agree that testing the patients sleep in their normal home environment offers many advantages to the laboratory setting that is admittedly uncomfortable for the patient.

    The process for this test is to have the primary care physician screen patients for sleep abnormalities during their routine visits. When abnormalities are found, the physician will dispense a take home device that they have available in their office. The patient will take the device home, wear it that evening while they sleep, and return it to the physician's office the next day. Results will be available usually within 24 hours. Based on the results, the physician can a) rule out OSA b) diagnose OSA and prescribe therapy or c) prescribe further testing or titration to be performed in a sleep laboratory using PSG. Prior to the home sleep test, only option 3 was available to primary care physicians at the expense and inconvenience of millions of patients.

    Home Sleep Tests (HST) usually monitor anywhere from 4 to 9 channels of data for the physician. This will usually include heart rate, respiration, respiratory effort, snoring, actigraphy (head movement/position), and oximetry (amount of oxygen in the blood). Some HST are sophisticated enough to even include EEG, EOG, and EMG making it clinically comparable to a laboratory PSG.
  • An overnight PSG (Polysomnogram):

    This test is conducted in a sleep lab or hospital setting. It requires the patient to stay in the sleep lab of hospital overnight which can be inconvenient. It is an expensive process (hospital setting, sleep technician, often manual scoring) and many sleep centers are operating at full capacity so there is often a 3-4 week wait. We have found a 40% drop off rate from patients that are referred to a sleep lab to those who actually show up and complete the test. In addition, the patient is traditionally burdened with extra deductibles and charges ($700-$2500) since this is occurring outside of the primary care setting. It is widely agreed that PSG is a thorough and reliable test when the patient completes the process.