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Guide to Sleep Study Tests

Sleep study test

The first step to treating any form of sleep apnea is getting diagnosed. After consulting with your doctor, the first plan of action may be to get tested. There are a variety of sleep study tests that can be done either at home or in a lab. Learn more about what these tests entail, how to prepare for them, and more.

Home Sleep Test

The first type of sleep study test that you and your doctor may consider is a home sleep test. A home sleep apnea test (HST) is a sleep study test used for the diagnosis of obstructive sleep apnea (OSA). Home sleep tests usually measure the same biologic parameters. Here are the major elements that will be studied during your home sleep apnea test.

  • Nasal and oral airflow: Airflow data is collected by using a thin wire that is taped by the nose and mouth. Some sensors look like an oxygen cannula.
  • Respiratory effort: This element is tested with elastic belt bands that are placed across the chest and abdomen.
  • Oximeter finger probe: Data for this parameter is collected with a small, clip-like device that attaches to the fingertip. The device emits a red light that assists in the evaluation of oxygen levels in the blood while sleeping.

Once you have received your home sleep test, you will apply the sensors to your body before sleep time. Typically, you sleep with the equipment for one to three nights. After you have completed your nighttime monitoring, you will need to return the equipment to the diagnostic service company where the data is downloaded and processed for interpretation by a sleep physician.

After the home sleep test data is interpreted by a sleep physician, a diagnostic interpretation report is sent back to the ordering physician who discusses the results with you.

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Polysomnography Test

The other diagnostic tool for the evaluation of obstructive sleep apnea is polysomnography. A polysomnography test (PSG) is a diagnostic test similar to that of a home sleep test, but with additional measurements. It is done in a laboratory setting with a sleep technician or sleep technologist  and is often three times more expensive than a home sleep test.

A polysomnography uses the same sensors as a home sleep test, but also includes EEG, EKG, EMG, and other biologic measurements used in a laboratory setting. With the additional medical devices used in a polysomnography test, technicians are able to study a wide range of bodily functions. Here are a few of them.

  • Brain waves
  • Eye movements
  • Skeletal muscle activity
  • Heart rate and rhythm 
  • Blood pressure
  • Breathing patterns
  • Blood oxygen level
  • Body position

Sleep Apnea Test Criteria

Most insurance companies have specific criteria that are required in order for them to cover your sleep study test. These criteria vary from insurance payer to payer.

Generally, they require that you have specific symptoms prior to the sleep study. Also, many insurance companies need you to have a face-to-face visit with a physician prior to ordering a sleep study test. Most often, you will need to have some of the following symptoms: excessive daytime sleepiness (EDS), snoring, witnessed apneas during sleep, nighttime gasping or choking, or change in certain behaviors.

The criteria for having a home sleep test is often less cumbersome than that of an in-laboratory sleep study. For the latter, certain medical conditions are sometimes required to be present for you to qualify. These might include congestive heart failure (CHF), COPD, or other complex medical conditions.

During your office visit with your physician, you will be asked many questions relating to your sleep. The doctor may also refer you to a sleep doctor prior to the sleep study. A focused physical examination will include evaluation of your mouth and airway, heart and lungs, and possibly a neurological assessment.

Woman sleeping

Preparing For a Sleep Study Test 

Your main job during a sleep study is to sleep. It sounds pretty simple, but there are a few things you can do to prepare for your study.

  • Avoid using any gels or sprays in your hair before the study. These substances can prevent the electrodes from sticking to your scale properly.
  • Don’t take a nap before the study. Sleeping during the day may make it difficult for you to fall asleep during the study.
  • Avoid beverages that contain caffeine, which can also interfere with falling asleep.
  • Wear something comfortable to sleep in.
  • Bring any medication you need overnight, as well as clothes for the morning. Also, bring toiletries that you may need in the morning, such as a toothbrush or razor.

Having a sleep study or sleep apnea test is a common process. With a little preparation, your sleep study will go smoothly. Learn more about preparing for a sleep study.

Why It’s Important to Get a Sleep Study Test

Even though the cost and inconvenience of a sleep study test may be intimidating, it is important to get a diagnosis. Sleep is essential for good health and if you don’t sleep well due to a sleep disorder, it can affect all areas of your life. Productivity, mood, and motivation can all be negatively affected by poor sleep.

A medical history and a symptom review are not enough for your doctor to make a definitive sleep apnea diagnosis, which is why a sleep study test is so crucial. Getting an accurate diagnosis allows you to get the treatment you need to improve your sleep and overall quality of life.

Whether you decide to undergo a home sleep test or a sleep study test administered at a sleep center, you are one step closer to obtaining your sleep apnea diagnosis

Now that you know about the different types of tests, how they work, and best prepping practices, you’re ready to make an appointment with your doctor to get yourself on the path to a healthier and happier life. If you’re looking for a quick and easy way to see if you’re at risk for sleep apnea, take this quiz to learn your results. 


References

  1. Cruz, S. D., Littner, M. R., & Zeidler, M. R. (2014, October). Home sleep testing for the diagnosis of obstructive sleep apnea-indications and limitations. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25353100
  2. Punjabi, N. M., Aurora, R. N., & Patil, S. P. (2013). Home sleep testing for obstructive sleep apnea: one night is enough!. Chest, 143(2), 291–294. https://doi.org/10.1378/chest.12-2699
  3. What is "normal" sleep? (2016, December 30). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK279322/

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41 comments on “Guide to Sleep Study Tests”

  1. I had in home sleep test. Results are Moderate Apnea.

    I have a CPAP machine that I am told cannot be used. I must have an APAP machine if I want to be treated or come to the lab for a study that is more in depth!!!!

    The fact that I have Apnea - but can’t use my CPAP - Dr. knew I had the machine.
    Feels like a big money making racket. So very frustrated - insurance deductible not even close - out of pocket for new test would be $600. New machine ????? 7/17/2020

  2. Received home sleep test kit at 1:30 pm . Received statement on line 2:30 and read e-mail 8:30 pm. My surprise statement said Purchase and deliver of Home sleep test kit $795. My signature is on it. Of cause driver told me to sign on his phone. He never showed me any documents. I am not going to use it tonight. They never said about I have to purchase the kit. All I know is insurance company approved to test my sleeping behavior. By the time I read statement, it is too late to call the company.

  3. Hello, I've had to sleep test one four years ago in the lab, they said no sleep apnea and because I haven't lost my neck size but haven't gained any weight I had to have a home sleep study test and they said I scored 82%, is this passing and I think this is all a big scam for the Doctor's to make money, sure some people may have sleep apnea but not everyone does and just because your heavy they want to scare you into giving them money. To much

  4. This guide is very misleading and incorrect with the general cost expectations. My insurance was billed $1000 for a one-night take home study, one of the simplest tests they have. Nowhere near the $150-500 cost this article states.

  5. It's interesting how you said that a medical history and symptom description isn't enough for a doctor to make a sure diagnosis. Talking to a sleep apnea doctor and learning how to best take care of yourself would be really handy. That way you can be sure to learn about ways to figure out proper treatments, so long as your doctor can truly help you to diagnose what your problems are as well. That way you can treat the source rather than simply the symptoms.

  6. I am disputing a bill of $1300 for an at home sleep study that they are saying is an EEG Test.... I have to pay over $800 for the test after insurance. I could buy a CPAP out of pocket for this amount.... that could be my test.

    1. Just curious if you were successful in your dispute. I am being charged $588 for the doctor to read the result and they billed my insurance company $1,172 for the take home test (which my bill also said EEG - which I did not have). My insurance processed the claim for $3783 - subtracted my deductible and now they are saying I owe $1,300 for that procedure??!!...when the billed amount was $1,172.00 for that portion --- and I was told the take home sleep study would be around $400.00.
      I have not been successful in talking with my insurance company or the billing department at the sleep study center.

      1. Terri, I'm guessing you're paying a hefty monthly premium to your insurer for the privilege of having them jerk you around like that? I have catastrophic-only insurance ($10k out-of-pocket before any benefits begin) - so when I go to providers, I tell them upfront I'm uninsured and want their prompt-pay cash price. Amazingly, that price is often BELOW what the deductible portion was when I had a standard policy in force.

        To stay on topic: I am interested in doing an at-home study, but cannot find pricing anywhere on any of the equipment supplier sites (i.e. snapdiagnostics). Options to pay, sure, but no up front pricing. That makes me very leery.

        FWIW, you can find ring-like pulse oximeters on Amazon which log pulse and O2 sat every second for 16 hour intervals. That data is then offloaded to a smartphone via bluetooth. It not only displays your O2 values, but it flags drops beyond x% and can even vibrate to wake you if it drops below x%. While it's nothing like the data you'd get from an at-home kit (or sleep lab), it does provide valuable insight into whether you're de-saturating during the night - how often, and to what extent. Give that to your PCP, and they can decide whether you really need additional help.

        That said, such a logging oximeter is about $150 - and it's yours. You can share it with friends and family to see if they, too, may have an unrealized issue with sleep. You can also purchase a CPAP from Amazon (without script) for $500-700. So, all in, you can get a primitive diagnosis, and fix for less than the cost of these tests, post-insurance. Best of all, this can be accomplished without any entry in your medical record - which is critical for those who have CDLs.

  7. My doctor wants me to have a sleep study done. I don't understand why. I am having a knee replacement! I don't snore, I don't wake up gasping for air?? I am overweight, but healthy otherwise....

  8. Why do the home sleep study’s want you to wear a shirt under the machine? I normally sleep without anything on. Just curious.

  9. I am on oxygen 24/7 3 litters per minute and the lab tech told me I could not use my oxygen during the test. I told her I would be dead within a short period of time. So she told me to leave it off for 2 hours. WHAT IS WRONG WITH THESE PEOPLE!!! i CAN'T GO 20 MINUTES WITH NO OXYGEN, LET ALONE 2 HOURS. My Ox level goes down to 74 just getting up to get in the car!

    1. They don't listen, that's for sure. I'm so upset with the whole system, just because they don't listen. Actually, I am not surprised she ignored you. They have a one track mind and they don't care what is really going on with us. If something happened, they'd just say that they were staying within their limits. So find someone that seriously cares!!!!

  10. I'm getting ready to have one now and my insurance covers it besides a copay.
    I would call the insurance company and make sure the proper authorization was obtained if you needed one.

  11. Are home sleep studies covered by insurance if testing is for sleep apnea? I thought they were until I received a bill from the doctor's office for almost $300.

  12. As a kaiser patient for 21. yrs....they don't do over nite lab studies...I would flap like a fish for years...n was told by kaisers I was depressed because I slept during the day....I moved to Monterey county no kaisers here...had to get new insurance... n they sent me to sleep overnite lab....results was no where near kaisers home study...my quality of life has changed n I no longer flap like a fish...my move to Monterey county saved my life....keep fighting for our health rights ...never let a doctor out talk u about ur body ur health..we live in our bodies daily...peace n blessings to all...

  13. I hope this is the proper forum to ask this. I have used an oral device for over 5.5 years, and need a new one. Insurance did not cover it the first time, and I thought surely things would change when I was ready for a new TAP. I was very satisfied with it, other than the exorbitant price of both the device & sleep study. My question is this: Is there any way (including creative financing) that one can do for insurance to cover the cost of the oral device?

    1. If diagnosed they will not issue u a DOT medical card unless you can prove you are using your machine 70% of the time. The data is collected by your machine, and some offer a digital app for your phone. Others require you request a printout from your sleep managing supply company.

  14. I was recently charged more than $700 AFTER insurance for a home sleep study. Just checked, and they billed $1500 to insurance.

  15. We receive about 1000$ in our lab. have to pay for the technician (30/hr), rent, software, equipment, cleaning service, biller, and manager to arrange and then f/u the study. Its not just the study. 3-5k is crazy. 350 for home sleep study is norm but it has its shortcomings.

    I haven't been paid in rupee yet.

    Best advice is shop around for pricing. If they won't give it to you don't go. And there are internet providers of home sleep testing that may be reasonable. No doc to follow up with you though.

    Best to all.

  16. Lab sleep studies are a joke too. Ever try sleeping in a small sterile room, a lot like a prison cell, where they put you in a dinky bed, shut the lights out at 10PM and tell you to go to sleep. Fat chance if you have insomnia.

  17. How many hours does a home sleep study have to be for it to be billable for insurance? I can't get any insurance company to answer that questions.

  18. I'm at a truck driving school and I was told that I might have sleep apnea. They sent me home because they want me to have test done. I don't have any insurance or way of getting the money. Is there any services that may do it for me.

    1. You messed up when you answered the questions for the dot physical.They are not interested in your health.The doctor doing the dot physical is only interested in the dot requirements.Tell them what they want to hear or you wont pass the physical.Like I said they are not interested in helping you with any health issues.If you are not really over weight sleep well your fine.Every body has apnea they just started using it as an excuse to limiy liabilities.

      1. being overweight is only one cause of OSA, a sleep test must be done to know for sure.

        The doctor & DOT ares concerned about everyone's health. They don't want a driver falling asleep
        and causing an accident which can happen with OSA.

  19. i had one done but it's with a headband and it's so much easier than going to the sleep center. i got the results from my ent after words and he said my sleep apnea is a 12 which is not bad where i don't need cpap

  20. You could get this done in India for rs 15000 rupee. That's about 230 usd at a sleep lab. And have a nice vacation. Instead of bringing all the people over here on work visas just go over there it would be cheaper.

  21. I agree it should be done in a laboratory setting. It would be absolutely the best way to go. However, the home sleep study is 250, and most articles I read says the lab study can be 3x as much. I could deal with that but after checking, the sleep lab cost is 3650. That is almost 15x the cost of the at home. That's why Obama had to get involved and create this monstrosity called Obama-care. Health care field are thieves. I understand there should be no limits on what I would spend on my health but if you don't have it you don't have it.

  22. When I started in the sleep field, they used the pen and ink polygraph machines to measure sleep. It is amazing how new technology has miniaturized the ability to monitor sleep.

    Home sleep studies are really only good for one thing - sleep apnea testing. Everything else should be done in a sleep lab. For many complex patients, sleep apnea should be tested in the sleep lab too.

  23. My husband did home sleep test.... this is his third one the first two malfunctioned. Now he is not sleeping because he wants to make sure everything stays the same. He is not snoring groining or even jumping in his sleep. This is a big joke!!! Insurances should pay for it to be done RIGHT!!!!God KNOWS WEBPAY ENOUGH FOR INSURANCE! We have two! HisPRIMARY IS HUMANA AND HIS SECONDARY IS BC/BC!!! Call your congressmen and COMPLAINNIF YOU PAY A FORTUNE ON INSURANCE AND THEY DONT PAY FOR ANYTHING!!!!

    1. No. Change to a policy that pays for what you want. The only way to change this is if insureds make the market work by cancelling bad products and buying policies which offer the desired features. The best system is capitalism because the companies who serve the public, making them happy, get the business and make profits.

      1. Cynthia,
        Olandreaux is 100% correct! I am going through the same thing and am also furious! Your response to just choose a better policy is flippant and unhelpful. I didn't choose the policy I have. My employer of 15 years did. They were told at the end of the year last year that the employer insurance cost was going to double for the new year so they had to find a new insurance company quick. What we got was garbage. Which is worse-the crappy new insurance that wont cover the cost of a proper study or the old insurance that would cover it but, oh by the way, we doubled the cost of owning this insurance. It's all a racket.

    2. I went through both, a home study and an office study. The office study was worse! They kept waking me up every 30 mins to adjust everything and I never got accurate results because of it. In fact, they said I was fine. Still had horrible symptoms and my doc insisted I had sleep apnea. She then ordered a home test. Bingo! My oxygen was dipping into the low 60s. My biggest advice...get really tired before you go to bed.

  24. I had a dot recertification test and everything went fine except they saw that i take medications for diabetes and blood pressure.
    Now they want for me to take an sleep apnea test.
    Can i use the homesleep test for this.

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