Home sleep apnea tests don't always
detect cases of sleep apnea and most don't detect other sleep
disorders. Yet because they are inexpensive, many insurance carriers
are not allowing the sleep study labs, except as a last resort. The
Mayo Clinic does say the following: “Your doctor may make an
evaluation based on your signs and symptoms or may refer you to a
sleep disorder center. There, a sleep specialist can help you decide
on your need for further evaluation. Such an evaluation often
involves overnight monitoring of your breathing and other body
functions during sleep.”
Tests to detect sleep apnea may
include:
#1 - Nocturnal polysomnography.
During this test, you're hooked up to equipment that monitors your
heart, lung and brain activity, breathing patterns, arm and leg
movements, and blood oxygen levels while you sleep.
#2 - Home sleep tests. In some
cases, your doctor may provide you with simplified tests to be used
at home to diagnose sleep apnea. These tests usually involve
measuring your heart rate, blood oxygen level, airflow and breathing
patterns. If you have sleep apnea, the test results will show drops
in your oxygen level during apneas and subsequent rises with
awakenings. If the results are abnormal, your doctor may be able to
prescribe a therapy without further testing.
Portable monitoring devices don't
detect all cases of sleep apnea, so your doctor may still recommend
polysomnography even if your initial results are normal.
A USA Today story on the other hand
promotes home sleep study tests. While they do present both sides,
have no doubt that home testing is favored.
This is the attitude of many insurance
carriers. "You get to sleep in your
own bed with your own pillow," said Dr. Laddie Tackett, medical
director for Anthem Blue Cross and Blue Shield in Kentucky. "It
makes testing more accessible. It makes it more affordable. It
makes it more convenient." But many doctors are
skeptical. They say in-home tests -- which make up a small
percentage of overall sleep tests -- aren't as thorough as lab
testing.
The amount of data from a home study is
significantly less than what is obtained from a lab sleep study. I
can confirm that walking around with untreated sleep apnea is no fun
and can be very wearing on your body. It took me about three weeks
to feel fully rested and another month to feel like my body had
healed from the wear sleep apnea had caused.
The home study equipment varies, but
should include something that measures air flow, an instrument that
measures the effort people make during respiration, and a finger
device that measures blood oxygen saturation. The air flow sensor is
placed under your nose, the respiration effort belt goes around your
chest, and the oxygen saturation clip in put over your finger
(generally next to the thumb).
Tackett says the home study equipment
is relatively easy to use and most patients usually do well in the
home setting. There is much discussion still taking place about
where home testing fits into the overall sleep disorder setting.
The lab sleep study equipment is
extensive. It includes about 25 sensors for the head, legs, and
other body areas, two belts to monitor breathing and respiratory
effort, and snoring microphones. The equipment measures breathing,
air flow, respiratory effort, heart rate, oxygen levels, brain waves,
snoring, and leg movements. It can detect about 80 types of sleep
disorders.
Many doctors believe that it is a
misconception that patients always sleep better at home and I would
agree. Just knowing that your sleep study is being monitored with
equipment that can determine if it is just sleep apnea or has other
sleep disorders involved can make sleeping in a lab quite comforting.
Some patients will require lab tests
before a CPAP machine is prescribed to determine is there are other
sleep disorders present. Both the home and lab may have advantages
and disadvantages and this is why a sleep specialist should do a
proper assessment.
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