Home Sleep Test or Sleep Lab?

Hey Guys,

I recently was introduced to the concept of sleep apnea. I wake up tired even with 10 hours of sleep, so I believe I have some degree of sleep apnea. My question to the community is: Should I do a home sleep test or should i go in for a in lab sleep study. Are there any advantages of one over the other? I would like to hear from people who have experience with either method, or even both!

Thanks!
Mike

Sorry. I forgot to login to the account. Here is my screen name.

mcucla..... welcome to the forum.

A sleep study in a lab setting has its advantages over a home study in that they are using highly sophisticated equipment including EEG monitoring. However, some lab settings are not conducive to very good sleep. I was fortunate enough to go to a lab that was very good; had comfortable, bedroom like rooms; and was very quiet. I've read of others that were noisy, uncomfortable, and less than clean. So..... at home, you are probably more likely to sleep well, but the monitor they hook you up with doesn't gather all the data a lab study can gather.

I would vote for a sleep lab. The one I had was also very nice. You could have PLMS and that will not be detected at home.

Typically a home sleep test (HST) is much cheaper, quicker to be scheduled, more convenient, and you get to sleep in the comfort of your own bedroom. You are more likely to sleep like you normally do in your own bed compared to the strange environment of a sleep lab with strange night people hanging around, listening to you over microphones, and watching you through an infrared camera.

The people who own sleep labs like to scare you that HSTs will miss some conditions. This is true, but a very small segment have the conditions they are talking about.

Unless there are suspicions about other sleep problems, such as restless legs syndrome, I would go with the HST. Save some money and, very importantly, apply it toward the cost of a good data-capable CPAP with monitoring software.

What symptoms do you have besides waking up tired? Do you snore? Has someone noticed your breathing pauses while asleep? Any other symptoms?

Thanks for all of your replies.

@roster - I actually do snore, but I'm not sure if I actually pause when I'm sleeping. I also get tired during the day, and sometimes need a lot of coffee to keep me awake.

So far we have :

2 x Sleep Lab
1 x HST

I'd like to get some more feedback before I make a decision.

Assuming that you have insurance......ABSOLUTELY USE A SLEEP LAB!

If you are going to take a vote, you will choose a sleep lab. This is because people are largely unfamiliar with HSTs which only recently were approved by Medicare and insurance companies.

Here is a quote from Dr. Mack Jones, a retired sleep doctor who is author of Deadly Sleep, http://www.amazon.com/Deadly-Sleep-Your ... 695&sr=1-1.

.... couldn't agree more with you regarding the sad state of sleep medicine. It's a
shambles; the sleep industry is a failure. Many sleep labs are failing
to do their jobs and putting patients at risk from misdiagnosis, no
diagnosis, lack of educating their patients, no followup, and the list
goes on. Medicare and insurance companies are aiding and abetting this
boondoggle.

The false negative rate of sleep studies, even in accredited sleep labs,
borders on the criminal (these patients go home thinking they don't
have a problem to suffer the catastrophic consequences of their
misdiagnosis). Something must be done to correct false negative tests.
One way to is to reduce the number of in-lab sleep studies. Forty
percent of sleep apneics do not need a sleep study because they have
already been diagnosed by a witness. A majority of others could have a
home study or go straight to an ACPAP with a smart card (diagnosis and
treatment all in one). The complicated patient (those with CHF, COPD,
etc.) can see a sleep doc (good luck).

All physicians should be able to diagnose and treat their OSA patients.
It's not rocket science, even surgeons can learn how to do it.
http://www.sleepguide.com/forum/topics/ ... e-of-sleep

Well do you have good insurance that will pay for a lab sleep study?

they can run from about two to five thousand dollars.. some hospitals give a cash discount if you pay within two weeks.

at an home sleep test can run three hundred out of pocket.

In a lab study they will put electrodes on your head and they will put put them on your legs to see if you have leg movements during sleep
which can bother you..
and they put a microphone (TINY) under your chin to monitor your snoring..
and the can monitor your brain waves to see exactly what stage of sleep you are in when you have an event whether it is obstructive or
central ( brain not telling you to breath)
They can tell you how long you take to go thru a sleep cycle and enter REM sleep, which is where most people have their worst events.
They can tell you how many times you had arousals, or experiences where you drifted from one stage of sleep to another, and this too can
cause you to be very tired..
They will put straps around your chest to check your breathing, and I think the home study might have the chest straps too.. but not sure..
If you have a split night study, after you fall asleep for a few hours and are having events, they will come in and put a mask on you, and
hook you up to a cpap to see what pressure they need to stop your obstructive events.. If you have central apnea they will use a different machine
to help you breath. After your study, they will send the results to your sleep doctor, and in a couple weeks, they will tell you what they find,
and set you up with a machine and mask etc..

In a lab, you are in a strange place with wires all over you... most of the labs look like hotel rooms with tv's.. sometimes they MIGHT give
you a sleeping aid if youre an insomniac... If you can sleep anywhere, youll be able to sleep in the lab.

If you do the home study, its quick, and you get to stay at home.. but you dont get all the nifty information about your leg movements, your
arousals, and what your sleep stages are doing.. and some folks find that pretty facinating to know..
when else would someone be monitoring your brain wave patterns while you are sleeping?
I had a lab sleep study, and my husband went with me to check it out. Now he would do a lab sleep study if we didnt have to pay for it, but
instead is opting for home sleep study. I would do one again if I could afford it, because I only slept an hour in mine..
ALSO.. if you DONT sleep at all, some hospitals do NOT charge you for the lab study, mine said they would not.. I could not sleep because I was worried
about the cost of the study if I didnt sleep enough. If you have to pay for your lab study, be sure to find out what the specifics are if you dont
sleep at all or not enough for a diagnosis..

I didn't have a choice because Kaiser does ONLY home studies--they are less expensive and a good home study machine will give sufficient information to diagnose sleep apnea. The caveat is that if you have something less common like PLMD is just may not pick it up. (Maybe you could videotape yourself if you believe this is an issue).

In many ways, I'm glad I have Kaiser. The real truth is that if I had to do a sleep lab test, I would NEVER have done it. I would never be comfortable enough to sleep with sensors pasted all over my body, in a strange bed, with people watching me. I have a touch of insomnia already and can't sleep the first night or two in an unfamilliar bed (i.e. a hotel room) so there is NO way I was going to be able to sleep in sleep lab conditions, and I would have been mortified by the entire process.

The other advantage to a home study has already been pointed out. It's YOUR bed, your environment and routine, and your usual sleeping conditions. Maybe that's even more accurate than a study in a sleep lab. The home study machine Kaiser uses is an older version of the Itamar Watch Pat http://www.itamar-medical.com/Product.asp?pid=3006 which was very comfortable and easy to use. It measures a lot of good information, and there is published, peer reviewed data on this test. Medicare has approved this test for home use.

I had very severe apnea, and I'm fortunate that Kaiser did the home testing ,because I went to their informational meeting with every intention of refusing a sleep test since I thought it would be in lab. My life was in danger by my attitude, but truly I would NOT have been tested if a home test wasn't offered. Just my two cents worth.

LSAT wrote:Assuming that you have insurance......ABSOLUTELY USE A SLEEP LAB!

Attitudes like that are a big part of what makes U.S. medical care and insurance so expensive.

The false assumption that "someone else is paying".

roster wrote:

LSAT wrote:Assuming that you have insurance......ABSOLUTELY USE A SLEEP LAB!

Attitudes like that are a big part of what makes U.S. medical care and insurance so expensive.

The false assumption that "someone else is paying".

Roster...Curious...Did you have insurance when you had your first titration? And if you did...did you ignore it and pay for your own procedure?

Touche!

I vote sleep lab.... leave it to the professionals.

Sheriff

My vote would be for the home study for all of the reasons already mentioned. I just think you would sleep better and get better results and readings. And yes, if there is the possibility of other things going on like RLS and other sleep disorders then talk with your MD about it and you may have to do it in a sleep lab. Good luck!

rosie