Home sleep study vs. in lab, also - hire online?
August 30, 2017 7:42 PM   Subscribe

Special snowflake question about doing a sleep study. Sleep techs out there?

I need a sleep study. I have late-onset insomnia and other issues, and want to rule out sleep apnea, at the very least. Due to our pathetic health care system1, I'm looking at $900 out-of-pocket costs to do an in-home sleep study, where I hook up a bunch of gear (something like this) and then have a consult to review the results.


* What is the different between what is measured in a sleep lab vs. what is measured by the home version? I'm positive I'll have a really rough time in the sleep lab, I'll hardly sleep at all, so the home kit seems more likely to yield useful results.
* Are there national sleep labs that will mail me the gear, I do the study, mail it back, and consult via phone/email? Since I'm paying out of pocket, it benefits me to find out.

[1] High deductible plan, opaque pricing structure, bureaucracy, and so on...you know the drill.
posted by falcon42 to Health & Fitness (4 answers total)
Best answer: Ouch, this is so hard. If you can swing it, make sure you are seeing someone with actual sleep medicine experience such as having completed a fellowship.

Some sleep disorders take forever to diagnose, and ruling out sleep apnea is indeed the first step. I've had a few sleep studies, but always in a lab. I have a couple of sleep disorders, including obstructive sleep apnea, so have been through the ringer. If your goal is to rule out apnea and the costs are less, then I'd think at-home would be fine. If there's apnea, the at-home test will show it (or else providers wouldn't judge it to be a useful tool, right?), and then you can deal with getting it treated.

If it turns out there is no apnea, and you want to see what the deal is, then you'll need to do a daytime test (Multiple Sleep Latency Test) that has to be in a clinic immediately following an overnight polysomnogram (PSG) that showed "normal" sleep efficiency. "Normal" primarily means "no apnea" not "slept perfectly." It's basically so that you had a good-enough night's sleep that the second-day results are not skewed. I didn't fall asleep for over an hour, and it was good enough still.

Generally the process is pretty straightforward, but can be very slow if your problem is not (just) apnea. I had a couple of overnights in a lab. One many years ago that didn't show apnea, and then one about five years ago that did. I got a CPAP, but it didn't help that much. I finally went back this spring because I was at wit's end, and my overnight PSG and my followup MSLT finally showed what the problem was. I got medicine for the underlying problem, and my life is getting back on track.

Good luck. A friend of mine reminded me that sleep deprivation is used as a torture device, so also know that the fact you are feeling bad is absolutely valid.
posted by Stewriffic at 4:20 AM on August 31, 2017

Best answer: I am a PA and I work in sleep medicine. I can't give you specific medical advice and tell you to get one type of study or another. I know money is a concern but you should really have a consultation and let the trained medical professional tell you whether or not you should have a home sleep test (HST), an in-lab study (PSG), or nothing at all. HSTs will only ever tell us if a patient has OSA. If, based on what someone tells us during initial interview, there is any reason to suspect the existence of another sleep disorder (alone or overlapping possible OSA) I will always counsel for a PSG. That being said, if money was an issue and the patient had a high likelihood of OSA regardless of possible confounding sleep disorders, I would order an HST first.

I don't know if any accredited sleep clinics that would ever send out an HST without either a consult in the office or a direct referral from a PCP on behalf of the patient. We would decline to do that in our clinic.

Good luck. Sorry the healthcare system is so expensive.
posted by teamnap at 6:13 AM on August 31, 2017 [1 favorite]

I recently did a home sleep study prescribed by a doctor. The results came back with severe apnea. And now I have to do a lab sleep study because the doctor wants to be sure that the results are accurate. Both studies are covered by my insurance so I'm not out-of-pocket, but if I was I'd be pretty annoyed that we even did the home study at all. You might want to consult with a doctor before shelling out for a home study to see if they'll make you repeat with a lab study.
posted by Pineapplicious at 7:18 AM on August 31, 2017 [1 favorite]

Response by poster: Thanks, all!
posted by falcon42 at 9:56 AM on September 16, 2017

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