If you snore loudly, wake up gasping, feel exhausted during the day, or have been told that you stop breathing while sleeping, your healthcare provider may recommend testing for sleep apnea.
But where should that testing happen?
For some adults, a Home Sleep Apnea Test (HSAT) may be appropriate. For others, an overnight in-lab sleep study, called polysomnography (PSG), provides the more comprehensive evaluation that is needed.
Although both tests can be used in the evaluation of obstructive sleep apnea, they are not interchangeable for every patient.
Understanding the difference can help you know what to expect.
What Is a Home Sleep Apnea Test?
A Home Sleep Apnea Test, often abbreviated HSAT, is a portable sleep test that you use while sleeping in your own home.
Depending on the equipment being used, sensors may monitor measurements such as:
- Airflow or breathing
- Respiratory effort
- Blood oxygen level
- Heart rate
- Other breathing-related signals
You receive instructions for applying the equipment, wear it while sleeping, and return the equipment or transmit the recorded information according to the sleep center’s instructions.
The recorded data is then reviewed as part of your medical evaluation.
The Main Advantage: Convenience
For an appropriate patient, HSAT can make testing relatively simple.
You can sleep in your own bed, follow your usual bedtime routine, and avoid spending the night in a sleep laboratory.
However, convenience does not mean that an HSAT is the best test for everyone.
What Is an In-Lab Sleep Study?
An overnight in-lab sleep study is called polysomnography, or PSG.
Instead of concentrating primarily on breathing-related measurements, polysomnography records multiple signals while you sleep.
Depending on the study, these commonly include:
- Brain-wave activity
- Eye movements
- Chin muscle activity
- Leg movements
- Airflow
- Chest and abdominal respiratory effort
- Blood oxygen saturation
- Heart rhythm and heart rate
- Body position
- Snoring and other relevant signals
Together, these measurements allow trained sleep professionals to examine not only how you breathe but also when you are actually asleep, which stage of sleep you are in, whether your sleep is being disrupted, and what other physiologic changes occur during the night.
A sleep technologist monitors the recording throughout an attended study and addresses technical problems that occur during testing.
HSAT vs. In-Lab PSG: What’s the Biggest Difference?
The biggest difference is the amount and type of information collected.
An HSAT is designed primarily to help evaluate certain adults for obstructive sleep apnea.
An attended polysomnogram provides a much more comprehensive picture of sleep.
Because a standard in-lab PSG records brain-wave activity and other signals used for sleep staging, it can determine when you are awake and asleep and identify different stages of sleep.
Many common HSAT systems do not measure sleep in the same comprehensive way.
That distinction can matter when interpreting the results.
Who Might Be a Candidate for a Home Sleep Apnea Test?
An HSAT may be appropriate for certain uncomplicated adults who have symptoms suggesting an increased risk of moderate to severe obstructive sleep apnea.
Possible warning signs of OSA include:
- Loud, habitual snoring
- Witnessed pauses in breathing
- Gasping or choking during sleep
- Excessive daytime sleepiness
- Waking unrefreshed
- Morning headaches
- Difficulty concentrating
- High blood pressure in combination with other symptoms
The decision should not be based simply on snoring or on a person’s desire to buy a sleep test online.
A healthcare provider should determine whether an HSAT is medically appropriate.
When Might an In-Lab Sleep Study Be More Appropriate?
There are many situations in which a healthcare provider may recommend polysomnography rather than home testing.
For example, in-lab testing may be preferred when there are certain significant medical conditions or concern about sleep disorders that cannot be adequately evaluated with a typical HSAT.
An in-lab study may also be appropriate when symptoms suggest something other than straightforward obstructive sleep apnea.
Your healthcare provider considers your symptoms, medical history, medications, other health conditions, and the reason for testing when deciding which study is appropriate.
What If My Home Sleep Apnea Test Is Negative?
This is an important point.
A negative home test does not necessarily mean that your sleep concerns should be ignored.
If an HSAT is negative, inconclusive, or technically inadequate but obstructive sleep apnea is still suspected, an attended polysomnogram may be recommended.
This is one reason sleep testing should be part of a broader clinical evaluation rather than treated as a stand-alone number generated by a machine.
Can an HSAT Diagnose Every Sleep Disorder?
No.
A Home Sleep Apnea Test is primarily intended for evaluating obstructive sleep apnea in appropriately selected patients.
It is not a general test for every possible cause of poor sleep or daytime fatigue.
Symptoms such as excessive sleepiness, insomnia, unusual movements, abnormal nighttime behaviors, suspected narcolepsy, certain breathing disorders, or other sleep-related concerns may require different evaluation or testing.
If your main complaint is simply, “I am always tired,” it is important not to assume automatically that obstructive sleep apnea is the cause.
Can I Just Buy a Home Sleep Test and Diagnose Myself?
Sleep testing should not be treated like a consumer wellness gadget.
A Home Sleep Apnea Test is a medical assessment.
The decision to perform the test should be based on an appropriate medical evaluation, and the recorded data needs appropriate review and interpretation.
An automatically generated result by itself should not replace professional evaluation.
What Happens If Sleep Apnea Is Found?
If testing indicates obstructive sleep apnea, your healthcare provider can discuss the severity of the condition and appropriate treatment options.
Depending on the individual, treatment may include:
- Positive airway pressure therapy such as CPAP
- Lifestyle and weight-management measures when appropriate
- Positional approaches in selected patients
- Oral appliance therapy in appropriate cases
- Surgical or other treatment options for selected patients
- Management of contributing medical or anatomical factors
The appropriate treatment depends on much more than simply whether the test says “positive.”
Is an In-Lab Sleep Study Uncomfortable?
Seeing photographs of someone connected to numerous sensors can make a sleep study look intimidating.
The testing is non-invasive.
Sensors are placed on the scalp, face and body, respiratory belts are positioned around the chest and abdomen, and other sensors monitor breathing and oxygen levels.
You are then given an opportunity to sleep.
You do not have to sleep perfectly for the study to provide useful information.
Sleep technologists understand that sleeping in an unfamiliar room while wearing sensors is different from sleeping at home.
Their job includes obtaining a technically adequate recording while helping make the experience as comfortable as possible.
Which Test Is Better?
Neither test is automatically “better” for every person.
The better question is:
Which test is appropriate for your particular symptoms and medical situation?
For a carefully selected adult with a strong suspicion of uncomplicated obstructive sleep apnea, HSAT can be a convenient diagnostic option.
For someone with certain medical conditions, complicated symptoms, an inconclusive home study, or concern about other sleep disorders, an attended in-lab polysomnogram may provide information that a typical HSAT cannot.
Don’t Ignore Persistent Sleep Symptoms
Snoring is common, but loud snoring accompanied by pauses in breathing, gasping, choking or excessive daytime sleepiness deserves attention.
Likewise, persistent daytime sleepiness, unexplained nighttime behaviors, breathing difficulties during sleep, or chronically unrefreshing sleep should not simply be accepted as normal.
The first step is not deciding for yourself whether you need a home test or a laboratory study.
The first step is discussing your symptoms with an appropriate healthcare provider.
Sleep Testing in Richmond, Virginia
If you are experiencing symptoms of a possible sleep disorder, appropriate evaluation can help determine whether sleep testing is needed and which type of study may be suitable for you.
Call to discuss your sleep concerns or request an appointment:
(804) 897-1705
(804) 520-8932
Better Sleep. Better Health.
This article is provided for general educational purposes and is not a substitute for individual medical advice, diagnosis, or treatment. The appropriate type of sleep testing should be determined by a qualified healthcare provider based on the patient’s symptoms, medical history, and clinical circumstances.
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