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.

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.