Personal Exp. with In Home Testing for sleep disorders

[GumbyCT]

Has anyone used an in home testing service to screen for their sleep disorders? I am particularly interested if this service was used in CT.

Not for me - I had mine the ol' fashioned way. A loved one has been referred by their doc to use this method.

Any Pros or Cons?
Discussion?

[GumbyCT]

I can't believe that no one here has had any experience with "In Home Sleep Testing"?

[Sireneh]

My first sleep study was at home. The sleep doc looked at the results and said he strongly believed I had sleep apnea, but the home study did not give him the info he needed to diagnose it. So I shelled out the money for a sleep study in the lab. I should mention, however, that I don't have apneas but a lot of RERAs and I don't think those machines you take home are sophisticated enough to detect those. So if this person thinks they may have true apneas, then the home study may well be sufficient.

In fact, now that I think of it, my dad and the husband of a friend of mine both had at-home tests and never did go to a lab. They are both heavy-duty apnea sufferers.

[archangle]

Cons:

There are a lot of good reasons to have a "real" in lab sleep test. There are some dangerous conditions that may be missed on a home test, but found on a good in lab sleep test.

A home test might miss something and the patient might then assume he's OK and suffer from the consequences of not getting a good test and proper treatment.

There are varying levels of home tests. From things I consider to be scams to some pretty good tests.

An in lab test allows you to fix mask leaks, loose probe wires, etc. that will mess up a home test. Plus instruct the patient for optimal testing.

If you have a life threatening event during the test, you're probably better off in the sleep lab being monitored.

Be sure your insurance covers the home test. (Or the in lab test for that matter.)


Pros:

Cheaper. Maybe. There are some home test ripoffs.

Convenient. Maybe.

Home tests are getting better. A home test can find a lot of things that won't be found out with no test at all. It could save your life. If the home test correctly indicates you need CPAP and you get treatment, it's done you a big favor.

The home test tests you in your normal sleeping environment (except for the mask, CPAP machine, equipment, wires, etc.). Lots of people don't sleep well in the lab.

Getting a home test is probably better than not getting any test.

A well done test and good follow up may tell a patient he needs a "real" in lab test.

Some in lab sleep labs are just "run 'em through and get their wallet" organizations. As are some "home test" outfits.

[Bookbear]

It's especially important to verify that 1. your insurance will cover the fee for the in-home test, and 2, that they will accept the results as being enough to diagnose. At least in this area (soCal), many common insurance plans say no to both the above. As others have said, the in-home tests ARE getting better, but still lack the depth of data an in-lab test provides.

It would not surprise me to see insurance companies eventually getting behind a reliable in-home test (because of the decreased costs), and sleep labs resisting mightily (because of lost business).

[avi123]

del

[BlackSpinner]

I had a home test but it is considered a first step test here. If that doesn't answer the questions then a full blown sleep test is done. A home test will find the common garden variety of OSA in most cases. It did so in mine and i am happy. A friend had both and they are still searching for answers in her case. It shouldn't be an either /or situation. Like blood tests for diabetes the first is a simple test to set you on your way.

[physicsbob]

I had a friend that ran a clinic for truckers, her husband has sleep apnea, and when we visited them for a few days. After the first night when she heard me snore in the basement and their bedroom is upstairs on the other side of the house, she brought the test kit home that they used to test the truckers. I took the seven pages of printouts to my Doctor when I got home. The Doctor said that it looked like I had severe apnea, but for the insurance to approve treatment I would have to have a standard sleep test. So it took two trips to the sleep lab to get setup for my machine.

[Janknitz]

As you'll see in my post above I was tested at home with a pretty sophisticated device called an Itamar watch pat. It has a probe on 2 fingers and a recording device strapped to your wrist. It may not detect PLMD or RLS but it can accurately detect apnea disorders.

IMHO it's got a lot going for it. It tests under REAL sleeping conditions. I am someone who would NEVER have tolerated sleep lab testing and that means I'd STILL be untreated--I have pretty severe apnea with significant desats, so I consider the availability of home testing life saving in my case. True there is nobody to intervene in emergency conditions during testing--but that's just like any other night at home, so what????

My local Kaiser tests 50 - 100 people per week this way. They have a vested interest in accurate testing because they are also the DME provider and the theory is that treatment will save them money in the long run.

Titration is done at home as well using an Auto machine. I think they get a much more accurate titration over a week or morein your own bed. All of this is bolstered with a strong patient education program and as much support as you need by knowledgeable staff at no extra cost. It works.

When I hear stories of poorly educated staff, lousy sleep labs and bad DMEs I'm pleased to have these resources available.

[avi123]

del

[IDS2011]

A Home Sleep Test (HST) is used to determine Obstructive Sleep Apnea (OSA) only. It does not "miss" any diagnosis of any other disorders because it is not intended for such use. HST is intended for patients who exhibit clinical symptoms of OSA. Patients with other sleep disorders (i.e. Restless Leg Syndrome (RLS), narcolepsy, REM-behavior disorder), co-morbid conditions (which may impact the diagnostic relevance of the SaO2 data such as COPD or CHF), and patients in whom you only mildly suspect sleep apnea ARE NOT candidates for HST. Patients with hypertension or diabetes ARE candidates, as are those that exhibit symptoms of insomnia. 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

If you suspect you might have OSA, an HST is the best way to diagnose it. It is also the quickest, cheapest way. Our HST process is complete in 7-10 days. Whereas, it may take a month or two to even get an appointment in a sleep lab. However, as stated above, if you think you have something MORE than just OSA, then yes, a sleep lab is necessary.

Patients love HST because it is EASY, fast, reliable, inexpensive, convenient, and the most patient-friendly diagnostic option for OSA. If you have any questions re: HST, please feel free to contact me!! We do over 600 HSTs a month and have had MANY satisfied customers! I'll be happy to help you however I can!

Thanks so much!

Stacie Felice
Instant Diagnostic Systems

[avi123]

As I understand it, many local DMEs do a PSG either at home or at their place. Let me find more details.

[IDS2011]

As I understand it, many local DMEs do a PSG either at home or at their place. Let me find more details.

Medicare has made it very clear that they do not want the HME participating in the HST process. Other insurers seem to be following Medicare’s lead. It can be a very dangerous play for HMEs. Please see policies at the link below...

http://www.instantdiagnostic.com/ids/(S ... g_policies


You can also check our website for any further questions you might have concerning HSTs. http://www.instantdiagnostic.com


Thanks!!
Stacie Felice
Instant Diagnostic Systems

[avi123]

As I understand it, many local DMEs do a PSG either at home or at their place. Let me find more details.

Medicare has made it very clear that they do not want the HME participating in the HST process. Other insurers seem to be following Medicare’s lead. It can be a very dangerous play for HMEs. Please see policies at the link below...

http://www.instantdiagnostic.com/ids/(S ... g_policies


You can also check our website for any further questions you might have concerning HSTs. http://www.instantdiagnostic.com


Thanks!!
Stacie Felice
Instant Diagnostic Systems

Thanks Stacie, I think that I understand the issue. My local DME has first class lawyers. I doubt it that they would tarnish their reputation by having "close" relations with another company that does sleep studies. I also know about first class physicians who have "close relations" with next door PSG sleep clinics.

[avi123]

A Home Sleep Test (HST) is used to determine Obstructive Sleep Apnea (OSA) only. It does not "miss" any diagnosis of any other disorders because it is not intended for such use. HST is intended for patients who exhibit clinical symptoms of OSA. Patients with other sleep disorders (i.e. Restless Leg Syndrome (RLS), narcolepsy, REM-behavior disorder), co-morbid conditions (which may impact the diagnostic relevance of the SaO2 data such as COPD or CHF), and patients in whom you only mildly suspect sleep apnea ARE NOT candidates for HST. Patients with hypertension or diabetes ARE candidates, as are those that exhibit symptoms of insomnia. 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

If you suspect you might have OSA, an HST is the best way to diagnose it. It is also the quickest, cheapest way. Our HST process is complete in 7-10 days. Whereas, it may take a month or two to even get an appointment in a sleep lab. However, as stated above, if you think you have something MORE than just OSA, then yes, a sleep lab is necessary.

Patients love HST because it is EASY, fast, reliable, inexpensive, convenient, and the most patient-friendly diagnostic option for OSA. If you have any questions re: HST, please feel free to contact me!! We do over 600 HSTs a month and have had MANY satisfied customers! I'll be happy to help you however I can!

Thanks so much!

Stacie Felice
Instant Diagnostic Systems

Reply,

Stacie, one thing that you don't do is give a price list for the different tests that you do. How much would I pay privately if I do your routine PSG test in my home?