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Heart Health
Worried about sleep apnea? Home-based testing is now the norm
- By: Julie Corliss, Executive Editor, Harvard Heart Letter
If your bed partner complains about your loud snoring, it might be a disruptive nuisance — or something more serious. High-volume snoring punctuated by snorts, gasps, and brief pauses in breathing is the hallmark of obstructive sleep apnea.
Although this condition occurs most often in men over 40 who are overweight or obese, it can affect people of all ages and sizes. The resulting daytime sleepiness — a direct result of not getting enough high-quality sleep — can leave people moody and forgetful. Even more worrisome: car accidents are two to three times more common in people with sleep apnea. Sleep apnea also can boost blood pressure and may increase the risk of clogged heart arteries, heart rhythm disorders, heart failure, and stroke.
What is the STOPBANG test for sleep apnea?
The easy-to-remember acronym STOPBANG can help you decide whether it’s wise to talk to a doctor about having a sleep study to determine whether you have sleep apnea. It helps to have input from someone who sees you sleep.
| A “yes” answer to three or more of these questions suggests possible sleep apnea. Ask your doctor if you should have a sleep study. | |
| S | Snore: Have you been told that you snore? |
| T | Tired: Do you often feel tired during the day? |
| O | Obstruction: Do you know if you briefly stop breathing while asleep, or has anyone witnessed you do this? |
| P | Pressure: Do you have high blood pressure or take medication for high blood pressure? |
| B | Body mass index (BMI): Is your BMI 30 or above? (For a calculator, see /bmi.) |
| A | Age: Are you 50 or older? |
| N | Neck: Is your neck circumference more than 16 inches (women) or 17 inches (men)? |
| G | Gender: Are you male? |
Sleep monitoring can be done at home
Diagnosing sleep apnea is less complicated that many people realize. In the past, diagnosing this condition always required an overnight stay in a sleep lab. “Today, about 60% to 70% of sleep studies for suspected sleep apnea are done using home-based tests,” says Dr. Sogol Javaheri, a sleep specialist at Harvard-affiliated Brigham and Women’s Hospital. If your symptoms suggest moderate to severe sleep apnea and you don’t have any other significant medical problems, home sleep monitoring is almost as accurate for detecting apnea as a night in a sleep lab, she says.
So, if you suspect you have sleep apnea, ask your doctor for an evaluation. Or if your health insurance allows you to see a specialist without a referral, you can start there instead. “Sleep specialists are better versed in insurance-related barriers, and they know how to order testing to avoid problems and delays in care,” says Dr. Javaheri.
For the test, you’ll get a small, lightweight monitor, a belt you slip around your midsection, a small finger clip that monitors your oxygen, and an airflow sensor to place under your nose. These sensors and devices measure your oxygen saturation, heart rate, and airflow, as well as the movements of your chest and abdomen and your position while you sleep.
One main advantage of home-based testing is the cost, which runs between $150 and $500, compared to testing done in a sleep laboratory, which usually tops $1,000. But the best part about home sleep test is the convenience. You sleep in your own bed, not an unfamiliar hospital bed, and you do the test based on your schedule. However, you’ll need to borrow the monitor from a hospital sleep lab, and you may have to wait a few weeks to get it. Later, if you are diagnosed with sleep apnea, home-based tests also provide an easy way for a physician to check how well your treatment is working.
Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
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Snoring and Sleep Apnea
This Harvard Medical School guide explains the physical traits and lifestyle habits that contribute to both snoring and sleep apnea. It describes simple things you can do to prevent snoring and offers advice on devices and procedures that may help treat stubborn cases. You’ll also learn whether you should be checked for sleep apnea—and what that testing entails. In addition, you'll receive details and advice about using positive airway pressure (PAP), the gold standard treatment for sleep apnea, as well as several other therapies.
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In people with simple snoring, the airway remains open. Sleep apnea is a different story: people temporarily stop breathing many times a night. In people with the most common kind, obstructive sleep apnea, the soft tissue of the palate or pharynx completely closes off the airway. The brain, sensing a drop in oxygen, sends an emergency “Breathe now!” signal that briefly awakens the sleeper and makes him or her gasp for air. A far less common form of this problem is known as central sleep apnea.
How do you know if your snoring is a sign of sleep apnea? In addition to loud, persistent snoring, people usually have pauses in breathing accompanied by gasps and choking noises. Often, people don’t notice these symptoms themselves, but only learn about them from a bed partner or family member.Another telltale sign that should prompt a visit to your doctor is nodding off during the day—a direct result of not getting enough high-quality sleep at night.
Other symptoms that may be caused by sleep apnea include the following:
- nighttime restlessness
- trouble sleeping, with frequent awakenings
- difficulty with concentrating or thinking
- memory problems
- mood changes
- morning headaches
- vivid, strange, or threatening dreams
- nighttime waking to urinate.
Although daytime sleepiness is common with sleep apnea, some people are so used to sleep deprivation that they don’t realize they’re sleepy. Instead, they may see themselves as lazy, lethargic, or not very motivated. Or they may not think it is unusual to fall asleep at a movie or while sitting at dinner with friends. The less appropriate the circumstances (such as waiting in traffic while driving, or during a conversation), the more dangerously sleepy you’re considered to be. In fact, excessive daytime sleepiness can be one of the deadliest complications related to sleep apnea.
