Home sleep apnea testing for obstructive sleep apnea in adults
- Nancy Collop, MD
Nancy Collop, MD
- Editor-in-Chief — Sleep Medicine
- Section Editor — Sleep Related Breathing Disorders
- Professor of Medicine and Neurology
- Director, Emory Sleep Center, Emory University
Home sleep apnea testing (HSAT), also referred to as out-of-center sleep testing or portable monitoring, is a diagnostic test used to diagnose obstructive sleep apnea (OSA), a disorder characterized by repetitive episodes of apnea or reduced inspiratory airflow due to upper airway obstruction during sleep. It has evolved as an alternative to overnight, attended, in-laboratory polysomnography (PSG) in selected patients.
Advantages of HSAT include its convenience (it can be performed in the patient's home or in a hospital room) and its potential to lower costs, since most HSAT devices are less costly than complete polysomnography systems and the attendance of a technologist is not required. A disadvantage is that for most of these devices, fewer physiologic variables are measured than with PSG, which can lead to misinterpretation of the results. Other advantages and disadvantages are listed in the table (table 1).
The United States Centers for Medicare and Medicaid Services (CMS) guidelines state that results from HSAT can be used to support a prescription for positive airway pressure therapy . The American Academy of Sleep Medicine (AASM) has also released clinical practice guidelines to guide clinicians in the use of HSAT [2-4].
The use of HSAT in the diagnostic evaluation of suspected OSA is reviewed here. The diagnostic approach to a patient with suspected OSA is described separately. (See "Clinical presentation and diagnosis of obstructive sleep apnea in adults".)
TYPES OF MONITORING DEVICES
Four types of sleep study monitoring devices have been defined [2,5]. Type 1 is an in-laboratory polysomnogram that cannot be performed at home. All others (types 2, 3, and 4) are portable devices that are considered as “adequate” for home sleep testing.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- TYPES OF MONITORING DEVICES
- In-laboratory devices
- - Type 1 devices (overnight polysomnogram)
- Home devices
- - Type 2 devices
- - Type 3 devices
- Limitations compared with PSG
- - Type 4 devices
- Alternative classification
- - Limitations
- PULSE OXIMETRY
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS