Home Sleep Tests (HST)
There is a lot of confusion over sleep testing, whether it be in the sleep laboratory of the home. Sleep testing can absolutely make you feel overwhelmed – so what are your options?
Home sleep tests are often the more cost-effect and convenient option for those who may be suffering from obstructive sleep apnea, (OSA) a common sleep disorder affecting millions every year.
Do you need a Doctor’s Prescription for a Home Sleep Test?
Like most medical tests, you need a doctor’s prescription in order to get a home sleep test. This may change but at present your doctor should prescribe it – that’s why they get paid the big bucks. This process may be tricky if you have insurance as third party carriers are answerable to their shareholders and not you, the end user.
In may be a generalization but most insurance companies are in it for profit – your insurance provider is always going to be more interested in the bottom line than ensuring that you get exactly what you need, especially if you think you are only suffering “mild” side effects of OSA.
However, you can absolutely get the home sleep testing you need if you take the steps that you feel are right for your health. The home sleep test market is growing as people learn the risk they’re often being forced to take by poor access to testing.
Oftentimes providers work with you so you can get the testing required to start sleeping better. There are several options you should consider before committing to a provider or a testing solution, so be sure to do your research.
Are Home Sleep Tests more cost-effective than a lab Study?
While in-lab sleep tests are more detailed and look for other sleep disorders that are more challenging to diagnose, the exorbitant cost can be a big deterrent, especially for those who exhibit already clear signs of OSA.
The average in-lab sleep study is covered in Canada but can still often be run by those also providing CPAP and hence have a clear conflict of interest. This then is covered under MSP (in BS) but can otherwise run between $2,000 and $4,000, which is not an option for many who may still need testing. Sleep labs are very profitable.
Home sleep tests are known to be significantly cheaper, roughly one-third to one-fifth the cost of traditional sleep studies. Choosing to take a home sleep test can provide the diagnosis you need to sleep better without having to spend so time or in some cases, money.
It isn’t just the cost, time or inconvenience alone that makes us look more at home testing now than ever before. First there is a growing understanding of how large the problem really is.
Sleep clinics simply couldn’t cope if the numbers increase, insurances are paying less and less in the US and where socialized medicine exists (and most of these are running in the red), there is only so much to pay for these expensive tests. Lastly, Home testing equipment is getting easier to use and able to provide more information.
For instance, for those that want an oral appliance over the mask and hose of CPAP, there are predictive tests available that can provide an answer the their effectiveness up to 97% accuracy. This is called MATRx plus.
With a Home Sleep Test, you get to sleep in your own bed!
Those undergoing a traditional in-lab sleep study should prepare themselves for a night away, possibly two if clinicians don’t capture all the data they need.
Electrodes and wires get attached to the participant and it can make for a very frustrating experience, especially if you are fairly certain of your condition beforehand. In my opinion, such tests (referred to as level 1 tests) are ideally suited to more complex disorders although they do have a place in OSA, especially in more complex forms such as central apnea or mixed versions.
The at-home sleep study is a simple monitor you wear for one night that tracks your breathing and provides accurate data to help diagnose apnea events throughout the night.
You sleep in your own bed and control your surroundings, making for a more positive experience. Home Sleep Test are usually level 3 tests, although the very simple ones are level 4 and more difficult to diagnose from as the information gained is somewhat limited.
With a Home Sleep Test (HST), you can usually get the results from one relatively easy night.
An HST comes with several pieces of equipment that you will be able to wear and use relatively easily. Included with the unit is usually a portable sleep data monitor, a heart rate sensor, a nasal cannula, and a chest strap.
Along with the unit, you’ll get a set of detailed instructions so you can ensure you are wearing the unit correctly and that it will effectively record your sleep behaviours and biometric data.
User error can cause problems with a home sleep test, so it’s important that you review and follow the instructions of any device carefully or contact your provider’s customer care or support representatives if in any doubt. If you follow the instructions carefully, you should have no problems with your home sleep test.
Home Sleep Test data should still be read by a Board-Certified Sleep Physician
You do not need to do an in-lab sleep study to have your results read by a board-certified sleep physician. But, if you do choose to do an in-lab study, it could take several weeks, or even months, to get your results back because of all the extra data they analyze.
Home sleep tests, in comparison, have a much faster turnaround time and your results will still get interpreted by a sleep specialist.
After you return your testing unit, you’ll get a diagnosis and likely have one of your provider’s patient care representatives contact you. They will review your HST results and review your treatment options if you are diagnosed with sleep apnea.
This analysis and results process can take as little as 10-14 business days, so you know that you’ll start getting your treatment sooner rather than later.
Home Sleep Test results will help you get the treatment that’s best for you.
After you hear back from your provider’s patient care representatives, you can contact your doctor to review your treatment options.
Within sleep apnea treatments, continuous positive airway pressure (CPAP) and automatic positive airway pressure (AutoPAP) and the dental, oral appliance therapy (OAT) treatments are the most effective and most commonly used.
Depending on the severity or specific sleep problems, other options or even surgery may be considerations. Regardless of these, they will explain to you issues like weight loss, positional therapy and other sleep aids that will support any treatment indicated – it is important to know all of your choices.
Once you begin treatment, it’s common to start feeling better rested and aware of the improvements because you are likely now getting the restful sleep you need. Follow up and testing is valuable in assessing success as well as you are feeling better.
The process of securing a prescription for an Oral appliance, CPAP, BiPAP, or APAP machine can appear overwhelming, but through the easy process of a home sleep test, and consistently using your management approach, your quality of sleep will dramatically improve as will your quality of life.
The risk factors of untreated sleep apnea can be frightening but securing the treatment that is right for you can make all the difference.
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Dr. Stephen Bray 2020