Home sleep study and EEG/EKG?

[DougVK]

I noticed some people are doing home sleep studies and titrations. Do these home studies income everything an inlab study does such as PLM monitors, EEG monitor, and EKG monitor?

[BlackSpinner]

No
They are preliminary studies for standard run of the mill OSA. If you "pass" that (here at least) and it doesn't help you are sent for the more fancy study.

[DougVK]

What is the purpose then of doing a home study over a in lab one? Do some insurance require a home study to be done over an in lab one?

[Pugsy]

What is the purpose then of doing a home study over a in lab one? Do some insurance require a home study to be done over an in lab one?

Home study cheaper. If a person meets criteria with home study cuts costs significantly. For plain jane run of the mill OSA without any complicating factors it makes the diagnosis and one huge cost is eliminated. I think that even Medicare allows home study diagnosis. Seems like I read that somewhere. Whether an insurance company actually requires it over lab study, I have no idea. It's not real common yet but who knows in 5 years it may be very common as equipment gets more mobile and more technical.

[Janknitz]

Actually they are not merely "preliminary" studies-- they are good quality studies with at least 9 channels of data, but not EEG. They do a lot of cardiac parameters. For more info google "itamar watchpat" for example. However, the may not pick up issues like seizure, plmd, or rls.

Since the majority of people have simpler forms of SA, they are good for diagnosis and treatment in most (certainly not all) cases. It makes so much good sense to be tested in your own bed and under your own sleeping conditions which may be very different from the lab. It also makes great sense to titrate at home for the same reasons.

I think if more home testing was available more people would be tested and properly treated.

[DougVK]

Actually they are not merely "preliminary" studies-- they are good quality studies with at least 9 channels of data, but not EEG. They do a lot of cardiac parameters. For more info google "itamar watchpat" for example. However, the may not pick up issues like seizure, plmd, or rls.

Since the majority of people have simpler forms of SA, they are good for diagnosis and treatment in most (certainly not all) cases. It makes so much good sense to be tested in your own bed and under your own sleeping conditions which may be very different from the lab. It also makes great sense to titrate at home for the same reasons.

I think if more home testing was available more people would be tested and properly treated.

Without an EEG how can the machine know if you truly are sleeping and not just lying down?

[Bluecat]

Maybe be it's different in the States but in France, at my hospital they offer two different kinds of home studies.
"Respiratory study" which would ressemble what you describe.
"Full study" which includes EEG channels.
I did a full home study and the information was the same as what I had during the sleep study I had prior to my MWT.
For the full home study, I had to go to the hospital in the afternoon so that they could set up all the wires (had to wear a hat to go back home... so as not to look too strange )
When I went to bed, I just had to plug in 3 wires in the little machine they gave me.
All in all, very easy! (and you get to sleep in your own bed!!)

[IDS2011]

Hi DougVK!

Home Sleep Tests (HST) are readily available to anyone, you just need an order from your physician as with any medial test. The main issue for HST is whether or not your insurance will cover it. There are some providers who are on-board with it and others who seem to be dragging their feet where HST is concerned. As far as Medicare goes, they made a landmark decision to approve coverage for unattended Home Sleep Testing (HST) back in 2008 to qualify patients with Obstructive Sleep Apnea (OSA) for CPAP therapy. Other large commercial insurers, such as Aetna and Humana, quickly adopted similar policies. Many other insurance providers now allow HST for patients with a suspicion of Obstructive Sleep Apnea (OSA) based on a physician assessment.

The good thing about HST is that it is MUCH more affordable than going to a sleep lab if you suspect that you have OSA. It has been a great option for those who do not have insurance, their insurance will not cover HST or they have a VERY high deductible.

As someone mentioned in this thread already, HST is intended for patients who exhibit clinical symptoms of OSA only. Patients with other sleep disorders (i.e. Restless Leg Syndrome (RLS), narcolepsy, REM-behavior disorder), co-morbid conditions ARE NOT candidates for HST. Patients with hypertension or diabetes ARE candidates, as are those that exhibit symptoms of insomnia. OSA signs to watch for include:

•Loud snoring
•Witnessed apnea events
•Excessive daytime sleepiness
•Morning headaches
•History of high blood pressure
•Memory problems or poor judgment
•Depression
•Gastroesophageal reflux
•Impotence
•Nocturia
•Difficulty concentrating
•Personality changes or irritability

Feel free to visit our website at http://www.instantdiagnostic.com to find out what you need to know about HST. Simply click on the link for "Patient" on our homepage. There is information there to help you discuss HST with your physician, you can even download an order form for your physician. You may also contact me at any time with questions you might have at sfelice@instantdiagnostic.com

Hope this information has helped!

Stacie Felice
Instant Diagnostic Systems

[archangle]

Lots of people do not sleep well or don't sleep at all during in lab sleep tests. It's questionable how valid sleep tests in an abnormal environment are anyway. Sleep "labs" are popping up on every corner around here. Lots of people here have reported very badly run sleep labs. It's apparently very profitable to set up a sleep lab, run some sloppy tests, and milk the insurance.

If someone is really getting 50 hyponeas an hour, which is not uncommon, it should show up on a home sleep study. As long as you're using a CPAP machine that records waveforms, it shouldn't be too difficult to get an idea whether the patient is asleep, if they have apneas, etc. If you do a home sleep test, and the patient goes through a night or two with no apneas, he probably wouldn't have had any apneas in the lab test, either. If it's a borderline result, then you can go take an in lab sleep test later.