In home versus at center study

I'm slated for an in home study this week. I'm looking to get back on CPAP -- was diagnosed with slight sleep apnea 15 pounds and 5 years ago but went away from it.

Is there any chance the in home gives very inaccurate results?

There are varying levels of home studies depending on the number of channels (data points) they gather.
Some are simply overnight pulse oximeters and some pretty much do everything that an in lab study does.
Do you know what kind of home study it is going to be?
There are several different brands and types with levels of data gathered.

Fairly accurate though for whatever data they gather.

They are accurate enough that Medicare okays them for diagnosis.

Thanks Pugsy. I'm not sure which version but am encouraged by your reply. My fear is that I don't have apnea but yet, have all the symptoms of it

There's a couple that come to mind that are well thought of and I am sure there are others.

http://www.itamar-medical.com/watchpat-main/
Kaiser routinely uses the WatchPat for everyone who they think needs a sleep study. All are done at home first and the in lab stuff is saved for the problem cases.

ResMed has the ApneaLink
http://www.resmed.com/us/en/healthcare- ... k-air.html
it has 5 channels or things it collects data on

I wouldn't be afraid to use either of those or something similar.

I am not a fond of using overnight pulse oximetery only though...as the only thing that gets measured because not everyone has significant drops in oxygen with OSA. One of those things that a negative isn't necessarily a real negative but a positive is usually a real positive.

The in home tests are fairly accurate because they have to be approved by Medicare and meet certain standards. So I would not worry about that. I think in many ways they are MORE accurate, simply because they are testing you in your normal sleeping conditions, not in some artificial lab setting. You are likely to have better deep sleep to see what happens then.

However, if you have more than "run of the mill" obstructive sleep apnea--e.g. central apnea or mixed apnea, a home study is not necessarily best. So if your test doesn't indicate OSA but you still have apnea symptoms, or the prescribed treatment, when optimized, doesn't seem to be making a dent in your symptoms, then you may consider pushing for an in lab sleep test.

As an FYI, if you have Medicare, a home result that is borderline will usually be followed up with a lab study. I don't know what insurance companies do - probably up to them.

FYI, I ultimately had both studies: The lab study was to see if bi-pap would improve measures. For me, the home study appeared more accurate as I relaxed better, & stress of lab tech wanting to test four patients and get out the door at the first nod of her 10 hour shift made a lab situation even more stressful. I had a three minute sleep latency at home, versus an 87 minute sleep latency at lab! If your stress levels are so high you need an additional 90 minutes to fall asleep, I think this could affect outcomes. My O2 sats we're essentially the same for home and lab testing: do not understand, even if MD states O2 sats on titration studies are often as poor as no CPAP at all.

The home sleep test is not able to detect things like limb movements, grinding teeth, or other sleep abnormalities. Also the home test doesn't have a titration - where cpap used to find your working pressure.

IMO the split-nite in-lab is the most efficient in that the first 2 hrs are dedicated to diagnosis followed by titration if apneas, leg movements, or other abnormalities are detected. BUT you must sleep at either or it's a waste of time & money.

You can always ask your doc to prescribe sleep meds for the testing if you are the kind who has difficulty sleeping when away from home or with wires attached to your body. The key is to sleep during this sleep study.

Not any home study can't replace a lab study, though it can be enough to diagnose sleep apnea for most people.
Most people are ok with a home sleep study, the better home studies can do PLMD and mouth movement/muscle tension. It can indicate that it may be warranted to do a lab study.

Titration CAN be done at home with a full data APAP. Kaiser does it routinely. At home it can be done over several nights, giving you time to get used to sleeping with all the gear strapped to your face and in your own comfortable sleeping conditions. You get a better picture over the course of several nights than you do with a snapshot night in the lab under very artificial sleeping conditions.

And while you can use medications to help you sleep in a sleep lab, I've always wondered about the validity of the results because sleep medications definitely alter the quality of your sleep.

Janknitz wrote:Titration CAN be done at home with a full data APAP. Kaiser does it routinely. At home it can be done over several nights, giving you time to get used to sleeping with all the gear strapped to your face and in your own comfortable sleeping conditions. You get a better picture over the course of several nights than you do with a snapshot night in the lab under very artificial sleeping conditions.

And while you can use medications to help you sleep in a sleep lab, I've always wondered about the validity of the results because sleep medications definitely alter the quality of your sleep.

I don't disagree with the home titration or the snapshot points you make. In most cases whether dx'd in a lab or at home you will need to adjust or titrate yourself again and I think that is what this forum is very good at. And the reason to push for an auto cpap. The biggest problem is so many people have trouble learning just how to do that and it does take time. Then there are those who the lab may hit right on the money first time around.

Regarding the meds to sleep - I don't disagree there either but what is the point of paying all that money if you don't get to sleep? For any sleep study (home or lab) to be valid you must get to sleep. Exercise is always a good at inducing a good nites sleep but how many do that before a sleep study?

Then there are other meds that may interfere with sleep and combining that with nerves it can be a problem for some.

fwiw - I never took meds to sleep for a PSG and most times never felt well rested when leaving tho they always said I went right out. Yea, that's cuz I was sleep deprived.

There is a lot to consider and certainly no one size will fit all.