Sleep apnea home tests cheaper, may be more reliable than hospital tests

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DENVER — Doctors estimate that 18 million Americans have moderate to severe apnea, and 75 percent of them do not know it.

The condition not only makes you tired, it can also raise your blood pressure, cause your heart to beat irregularly and increase your risk of heart attacks and stroke. And if you’re apt to doze at the wheel after a rough night’s sleep, it could even lead to your untimely demise.

So how can you find out if you have sleep apnea? In addition to sleep center tests, which require overnight stays, at-home tests are growing in popularity. And not only are the home test up to $4,700 cheaper, some doctors believe they may be more effective.

NovaSom is one company that produces a home sleep apnea test. The company was founded by Dr. Michael Coppola, a former president of the American Sleep Apnea Association, and its $300 home test was reviewed by the New York Times.

Coppola said before starting the company, his team put together an estimate that suggested roughly $4.3 billion dollars is spent on sleep center testing each year

According to ClearHealthCosts.com, sleep center tests cost anywhere from $600 to $5,000 depending on your health insurance coverage. Home tests typically cost $300 or less.

Over the last 10 years, Dr. M. Safwan Badr, a past president of the American Academy of Sleep Medicine, told the Times that preferences have swung sharply in the direction of the home test — not only for patients, but for insurers. And it’s not just because of the cost.

Take the case of the Times’ Donald McNeil. When he took a test at a sleep center, he had been diagnosed with sleep apnea. When he took the home test, he wasn’t even close to that receiving the same diagnosis.

To be fair, McNeil said he lost 35 pounds between tests, and considering being overweight is one potential cause of sleep apnea, that could have contributed to the change in diagnosis.

However, due to the drastic change in test results, Coppola suggested the test may be to blame.

In his sleep center test, McNeil was diagnosed as having mild sleep apnea, which means he stopped or nearly stopped breathing for at least 10 seconds on five to 15 occasions per night. However, McNeil’s home test found that over the course of three nights, he stopped or nearly stopped breathing an average of 1.5 times a night.

Hearkening back to his sleep center test, McNeil recalled something that Coppola said hinders many sleep center tests: a slew of wires, probes and machines kept McNeil from sleeping the way he normally would.

In McNeil’s case, it forced him to sleep on his back, blocking an already narrow airway.

That said, the same things that offer a benefit the the home sleep apnea tests also come with drawbacks. Because of the lesser amount of tests and machinery, home tests don’t provide test subjects with as much data. For instance, since most home tests don’t measure brainwaves, the test can be fooled by someone who lies awake, staring at the ceiling all night.

Still, most doctors say home tests are useful for people who exhibit the warning signs of sleep apnea, such as waking up exhausted after a full night’s sleep or dozing off at the wheel during the day.

Those diagnosed with sleep apnea are typically advised to lose weight, drink less alcohol or caffeine and go to bed earlier. Additional treatment options include airway surgery or could sleeping with a CPAP (continuous positive airway pressure) machine that pumps air into the user’s lungs.

4 comments

  • thesumidaway

    I applaud you for writing an article about sleep apnea and making more people aware of it. The numbers are much higher than you stated. Based on NIH information, up to 20% of US Adults (48 Million) have sleep apnea and 90% of those people are undiagnosed (may not know they have sleep apnea). $300 is still a lot of money to know if you have sleep apnea or not. There are many simple indicators that can tell you if you have it when you wake up: high pulse rate in the 70s and above, headache, weak hands, high blood pressure, waking up suddenly with no noise to cause it, and others. – Jon Sumida (thesumidaway)

  • Michael

    Unfortunately, as a provider of both home and sleep center testing in California, I would like to point out that what this article fails to address is the limitations of the home sleep test and how those limitations result in a varied diagnosis and results. Before I go further I would like to point out that our organization began providing home sleep testing as a primary means of diagnosis, but expanded to include sleep center testing as well due to the testing and treatment limitations of home sleep tests. Each method of testing has its limitations, but as a patient/consumer its important to understand which one is right for you.
    Yes home sleep tests can be cheaper on a per night basis. But what people often fail to discuss is that many providers have patients use the devise on multiple nights, in which each night is billable to insurance and therefore can total equal to or more than a sleep center study. Additionally, a home sleep study is a scaled down version of what a patient receives in the sleep center setting. This means that not all parameters of sleep are measured, and its primary screening diagnosis is Obstructive Sleep Apnea (OSA), and it may not pick up other potentially serious sleep disorders. In fact, most home sleep devices can not completely define if a patient is sleeping and yet the data is still often included in the results. Also a home sleep test may fail to notify the patient if a sensor has fallen off, or is not working and therefore is not recording accurate or complete data. We see this all the time. A patient returns a home sleep test only to find out that the data is no good, and that the test needs to be repeated.
    Bottom line, before you have a sleep test, ask questions, and I mean alot. Do your research and pick a sleep testing company that you have personally reviewed and believe you can trust.

  • Dr. Safwan Badr

    A home study is potentially useful in establishing the diagnosis of sleep apnea, but it cannot rule out sleep apnea and is completely useless for any other sleep condition. In fact, a home study cannot even determine if the patient is awake or asleep. Imagine telling a sleepy patient that there is nothing wrong with her or him, based only on a limited home study. I wouldn’t accept such irresponsible practice for my loved ones and wouldn’t accept it for my patients. Knowing which sleep study “tool” to use requires the expertise of a sleep specialist who has the training and experience to evaluate multiple sleep-related diseases. Sleep represents one third of human life: Let’s give sleep disorders the same attention we give to other diseases.
    M. Safwan Badr, MD
    Past president of the American Academy of Sleep Medicine

  • Anonymous

    sleep apnea is based on per hour not per night as the article reads.
    mild is 5 -15 per hour
    moderate 16-30 per hour
    severe is over 30 per hour

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