Why You Can Trust CNET Sleeping Troubles? Use an At-Home Sleep Test to Assess Your Health
At-home sleep tests are devices used to screen for sleep apnea. But getting one isn’t as easy as adding it to your cart. You need to talk to your doctor.
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When it comes to sleep disorders, you need a diagnosis to help determine the next steps for your wellness. That's done through sleep studies. In the past, you'd be required to go into a lab or sleep center and stay the night. While this is still a widely used option, especially if you have several things to investigate, many cut-and-dry sleep apnea cases are done in your home now with an at-home sleep test.
"The process varies depending on the clinic you're in. Most primary care doctors for adults feel pretty comfortable screening for sleep apnea, which is the main medical disorder that a sleep study is checking for," said Dr. Sujay Kansagra, Duke professor of Pediatrics and sleep expert.
If you suspect you have sleep apnea, you're probably looking to use an at-home sleep test. I talked to sleep experts in the field to help determine who should get an at-home sleep test and how to do it.
What are at-home sleep apnea tests?
At-home sleep tests are exactly what you expect -- medical devices you wear while sleeping to monitor aspects of your sleep. They monitor the number of respiratory events that happen while you sleep. Some are as simple as a finger clip or wrist strap, while others also have chest sensors and nasal cannulas. Those best suited for at-home sleep tests are in need of confirmation of sleep apnea and have no other potential sleep disorders or conditions that would compromise results.
"At-home sleep tests are appropriate for patients at high risk for moderate to severe obstructive sleep apnea and who have the physical and cognitive abilities to set up and perform the study," said Joseph Krainin, M.D., FAASM, medical advisor for SleepApnea.Org.
At-home sleep tests are not over the counter in the same way that other medical devices are, like hearing aids or blood pressure monitors. You must consult a doctor to be prescribed and interpret the results of an at-home sleep study. That's because it's used to diagnose sleep apnea, a sleep disorder marked by frequent breathing interruptions caused by the muscles of the throat relaxing during sleep and blocking the airway. Obstructive sleep apnea most often requires using a CPAP machine to treat and manage the condition, which also requires a doctor's visit.
Read more: Is Your Smartwatch as Good as an At-Home Sleep Test?
The benefits of at-home sleep tests are obvious. Not only are they significantly cheaper than lab studies, but they're also significantly more convenient. You get to sleep with them at home, which is great for people with difficulty sleeping in new places. The process can also be quicker. Lab studies are often scheduled months in advance. But you can do your sleep test at any point after you get it.
What's the process for getting an at-home sleep test?
You can get an at-home sleep test in two main ways. The first is to meet with your doctor and discuss the possibility of sleep apnea. If the signs of sleep apnea are there, you get an at-home sleep test. Or your doctor may refer you to a sleep clinic for an assessment. Either way, the at-home sleep test is ordered for you. You'll often need to pick up the device from the doctor's office, or it will arrive at your home.
The other way to get an at-home sleep test is to order one directly.
"Typically, after you order the study, you will meet online with an appropriately credentialed and licensed health care provider who will review your case and approve the order if you are a good candidate for an at-home sleep test," Krainin explained. "Online at-home sleep test providers are usually cash-pay, but you may be able to obtain reimbursement from your insurer."
Even when you buy it directly, you will meet with the company's healthcare provider before to determine your need and after the test to interpret the results. So you shouldn't buy one without being certain you have sleep apnea. Otherwise, you may waste your money.
Does insurance cover at-home sleep tests?
Yes. Most insurance companies cover the cost of the at-home sleep tests, especially if you go through your doctor's office. "Insurance companies have found that at-home sleep tests cost less, so they push most adult sleep patients to try to get at-home sleep tests if they are safe to do so and it is clinically indicated," Kansagra said.
If you buy an at-home sleep test, you'll have to submit the cost to your insurance company for reimbursement. So you avoid the hoop of going in person to your doctors, but you've got the work on the back end to get your money back. Direct-buy sleep tests average around $200, though some options, like WatchPAT One, can be over $300.
There are limitations to at-home sleep tests
At-home sleep tests are good for what they're intended to do -- screen for sleep apnea. However, at-home sleep tests rely on the patient's ability to use the device and accurately annotate when they went to sleep and woke up. It sounds simple, but it opens room for errors a lab study doesn't have.
"The technology for at-home sleep studies has improved over the years, but there are still a variety of physiological factors that are best assessed in an actual sleep laboratory," Kansagra said.
Lab studies can diagnose a wider range of sleep disorders thanks to additions like EEG leads, respiratory sensors and leads on legs. According to Kansagra, you'll get a complete picture of everything your body does while you sleep.
Kansagra also pointed to another limitation of at-home sleep tests. "You don't get a sense of what stages of sleep you got into. So patients only have sleep apnea in REM sleep. Or only in REM sleep when they're on their back. And that type of granular information is much harder to get when doing an at-home sleep study."
At-home sleep tests are the best option for cases where your doctor suspects sleep apnea is the only issue. When things are more complicated, you're probably best going with a lab study that can test much more.
Read more: At-Home Sleep Tests vs. Lab Studies: Is At-Home Just as Good?
Too long; didn't read?
At-home sleep tests are a valid and popular option for screening for sleep apnea. They're cheaper and less of a hassle than in-lab studies. But that doesn't mean you should go out and order one even if you're sure sleep apnea is the thing that's hurting your health. You need to talk to your doctor first.
"I would highly recommend having a clinical assessment by either your physician or someone who specializes in sleep disorders, and if they deem it necessary, then they should order it through their process of getting an at-home sleep study," Kansagra said.
"Most primary care physicians will have an affiliation with some type of accredited sleep center that abides by standards around the type of tests they do and care they provide."
He explained that there can be variability in the care you receive based on which test you use. You should always feel confident in the route you choose.