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Accuracy of Home Sleep Studies?
#1
Question 
Accuracy of Home Sleep Studies?
Overall, how accurate have people found their home sleep studies.

Mine had some funny readings and I thought others might have experience with home sleep studies enough to say there are issues with them or... that while typically they are good yours does look like has some issues.

Here is the scenario:
I went to a sleep clinic for help with circadian issues (long time issues, fixed for many years but became an issue again recently).  A few days before my appointment I had started using a light therapy when I first woke (I had done this for years but after my move I thought I was getting enough light thru windows - turns out I was not at least not in the wintertime).  Light therapy, within 2 weeks or so of use, has fully corrected the circadian issues.

However, during my appointment the Dr seemed zoned in on the fact I likely had sleep apnea and that was causing my sleep problems (sleeping during the days not nights) despite the fact that I don't have obvious sleep apnea symptoms.
I am fully alert right when I wake up and I am not sleepy during the day.  I have more problems with falling asleep & staying asleep (I sometimes wake one time in the middle of the night for 30-120 minutes), than I do being sleepy during waking hours. 
I do mouth breath at times (when my nose is stuffy from allergies).
DH has said I stop breathing at night but just for a few seconds (no where near the 10 second length on the sleep apnea list) - this in particular seemed to be what the Dr zoned in on as evidence that I had sleep apnea.  She said it didn't have to be 10 seconds long of a pause to be sleep apnea. 
I have never had gasping or waking up in a panic or any of the other potential symptoms of sleep apnea.   No crazy adrenaline dreams.  No fatigue or feeling like I didn't get enough sleep or the other common sleep apnea symptoms.
But the Dr was really pushing that I needed to be tested for sleep apnea.

I agreed to the home sleep study since at that time I was not yet on a regular sleep schedule to be sure I would sleep whenever my appointment was and I was concerned about being able to sleep with all the wires/etc. on me.   
I had to ask for the EEG test which is what I went in for (to see sleep stages and see if that was showing sleep problems), the Dr did agree to that.

Well, the EEG test didn't work right, despite me doing several nights and the lights being on saying it was recording.  So no information from that.

The home sleep study.  It had the chest band that was worn right under the armpits (no belly straps and I can do more belly breathing than chest breathing).
It had the cannula [url=https://en.wikipedia.org/wiki/Cannula][/url]tube that has 2 prongs in my nose and went over the ears then attached to the device on the chest strap.  I asked several times are you sure this picks up mouth breathing inches away and was told adamantly each time that it did.  
The device had the hard oximeter that goes on the finger and attached to the device on the chest strap.
I tried to straighten out the cords / tubing when I put it on, but some tubes/cords seemed to have looped and curled over time and would not straighten out.

The home sleep study reported some very odd readings.
See the attached. I slept from 11:20 pm to 2:30 am.  From 2:30 am to 5:15 am I was awake lying quietly in bed reading a calm story.  I slept again from 5:15 am until the machine turned itself off (I woke up to a dead machine at 9:54.

But while I was awake calmly reading, the machine said I was snoring a lot (nope), had a couple apneas, had O2 desaturation down to about 84%, was upright for 23 minutes (nope, 2-3 min at most), and had times when my pulse went above 100 (low was below 40).
Also, I typically sleep on my right side, not supine, though I didn't write this down and would not remember for sure what happened weeks prior (when the test happened vs when I got the report).  So possible but not likely.

Because of the funny readings when I was awake.... it makes me question if the readings were accurate when I was asleep.


See the attached copies of the sleep study. 

Bottom line, I will likely get an APAP and use it's software to determine if I am actually having AHIs (rather than do a full sleep study during these more germy times and because I likely would have trouble sleeping with all that gear all over me).


Thanks for your input,
Jane


Attached Files
.pdf   sleep study report pg1.pdf (Size: 886.12 KB / Downloads: 17)
.pdf   sleep study report pg2.pdf (Size: 384.87 KB / Downloads: 18)
.pdf   sleep study report pg 3 redone.pdf (Size: 540.55 KB / Downloads: 15)
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#2
RE: Accuracy of Home Sleep Studies?
Hi Jane,
I have used the ApneaLink Level 3 home sleep study a few times and I believe it to be fairly accurate.
You make some good points, especially about the mouth breathing and having the nose flow sensor reading accurately.
The oximeter data is consistent with moderate sleep apnea. Having your oxygen saturation go below 90% or 88% for that amount of time should be addressed.
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#3
RE: Accuracy of Home Sleep Studies?
Mogy, Thanks
I am being unsure about the test accuracy not knowing exactly how it measures things but I know the oximeters themselves are reasonably accurate.  I am hoping the equipment was in decent condition but again unsure because the EEG machine obviously had big problems.  I know about aPAPs because my husband has used one for many years, so I figure be safe and get a machine to try.  I will check the reports and play with things and then review the data to see what it is saying - I would trust that machine software more than I trust the at home  sleep study (just because there is some questions that got raised).
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