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Home Sleep Study vs Clinical
#1
Home Sleep Study vs Clinical
I'm new here, and from the threads I've read it seems that most people here have had a sleep study in a clinical setting and it seems to be taken for granted that most people have had that kind of study.

My doctor started nagging me to go have a sleep study done about 20 years ago because he suspected sleep apnea. I didn't go because the nearest place was three hours away, I would have had a really hard time being able to take a couple days off of work and, honestly, I dreaded the idea of trying to spend a couple nights under the conditions I imagined it would entail. I hadn't been back to that doctor for 10 years (or any doctor for that matter). After hitting rock bottom with my apnea, I finally bit the bullet and made an appointment with him (I'm very stubborn and hard headed) with the expectation that he would set me up with the sleep clinic study that I was finally resigned to accepting as necessary in order to continue living. I was surprised when he told me that I wouldn't have to do that, or take any time off of work and I could have a small kit delivered to me at whatever hotel I was at in any state, wear it one night, pack it up, take it to the closest post office, send it back and get a diagnisis in a couple days. The results were not pretty. "Lucky to be alive" were the words my doctor used when he showed me the resuts.
Long story short: I've gone from having an unlivable life and probable early death to feeling great, AHI average 2.4, and SpO2 always above 92 while sleeping - at 97 most of the night.

I can't help but think that if the home sleep studies were available 20 or even 10 years ago or if I knew about them or if I found out about them when they were available; then I might not have come so close to hurting or killing myself and others on a regular basis, had such a progressively low quality of life or have possible permanent damage to my health.

Has anybody else here just had the home study?

Are there any big advantages to the clinical study?

Is the home study widely available?

What thoughts do you guys have on this? I may be wrong, but it seems to me that if the home sleep study was more widely known about, widely available and if it doesn't have any major drawbacks that I don't know about, then a lot of stubborn and hard-headed people like myself might not suffer and be such a danger to themselves and others.

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#2
RE: Home Sleep Study vs Clinical
Hi jgjones1972 and WELCOME! to the forum.!
I had two of the traditional sleep studies because the first time, I didn't get to sleep in time so I had to go back for a second time to be set up with a CPAP machine.
I could understand that there would be advantages to getting a home study but hang tight for more suggestions from someone more knowledgeable about your questions.
It's great that you finally got set up with a CPAP machine.
Best of luck to you with your CPAP therapy.
trish6hundred
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#3
RE: Home Sleep Study vs Clinical
most people done the sleep study in a sleep lab but some have home sleep study and its covered by some insurance
sleep lab study is preferable as it can tell more info ... if you have central sleep apnea or/and other sleep disorder which home study have limitation
btw your zodiac sign is not Taurus Too-funny Sleep-well
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#4
RE: Home Sleep Study vs Clinical
JG--I haven't had a home study myself, but I have the impression that the concept is fairly new and is growing in popularity, driven by the cost difference when compared to a study done in a sleep lab along with the growing number of people who are being found with suspected sleep apnea and for whom a sleep study is desired.
In a recent conversation with the director of my local hospital's sleep center, I asked her if they were going to get into home studies or already had started doing so. She said, yes, they had recently started using them and plan to be doing more in the near future. She told me home studies are beneficial where the patient does not have other complicating risk factors.
Six years ago when I had my first sleep study, this sleep center was not doing any home studies.
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#5
RE: Home Sleep Study vs Clinical
By far, the official sleep study is better due to less variables. But, a LOT of people just cannot sleep away from home and, like Trish, had to have it done twice.

Either way, the result is going on one night's worth of data no matter where you are.

My opinion is the home study is best but then they do it wrong. Have the patient do the home study then, if a diagnosis of SA is given, let them use an autoPAP for a week or two. This will give the best treatment for that person. Better yet, let them keep the autoPAP and teach them how to manage their own health.
PaulaO

Take a deep breath and count to zen.




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#6
RE: Home Sleep Study vs Clinical
Paula's idea of how a home study should be followed up with an auto machine for a few weeks to get the full and correct picture makes a whole lot of sense to me! What a shame the professionals haven't figured this out.
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#7
RE: Home Sleep Study vs Clinical
(11-24-2012, 07:01 PM)zonk Wrote: most people done the sleep study in a sleep lab but some have home sleep study and its covered by some insurance
sleep lab study is preferable as it can tell more info

Uh, not always. I was SO disappointed when my sleep study revealed that my pressure level hadn't changed. But yet I was still having breathing trouble - even during the damn sleep study! But it seemed that all was ignored. I wonder if they were asleep as well. And I'm probably half way through borrowing the S8 AutoSet and.... the stats indicate I'm anything but consistent. I'm surprised and disappointed that none of this was noted during my sleep study so it is not always the be all and end all.
So if I'm lucky enough to get someone to listen to me maybe there will be progress. If not, I'll try to take an average of my results (three weeks) and set it myself.
I hope most people have an easier time than this.
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#8
RE: Home Sleep Study vs Clinical
I had mine done at the hospital (sleep lab). My dad is in southern calif and had the home device set up by a large HMO down there, which didn't work for him. A sensor came off and the study didn't have enough data to be conclusive.
I asked the lab tech who did my study how accurate those home tests are and he said they will essentially tell you if you have apnea. Not as much data but enough to do the job. The hospital lab study uses 24 sensors and the home study type uses 4.
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#9
RE: Home Sleep Study vs Clinical
A home study, unless it has wires on your legs, cannot tell if a person has periodic limb movement disorder. Nor can it tell when you enter or leave REM sleep. It probably cannot even tell that you ARE asleep.

A sleep lab study can tell all that as well as a ton of other things. The problem, though, just like with the home test, it is for just one night.
PaulaO

Take a deep breath and count to zen.




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#10
RE: Home Sleep Study vs Clinical
An in lab PSG sleep study is enormously better than any home study as long as you sleep well. Unfortunately, many patients don't sleep well. Any doctor who sends a patient to an in-lab sleep study without a sleeping pill to take in case they can't sleep needs to be horsewhipped. Yes, a sleeping pill may skew the results, but not as much as not sleeping.

The quality and thoroughness of home sleep tests varies enormously. Even the simplest versions may give you a clear indication of apnea, but they may fail to detect apnea in some patients with severe apnea. Unless you have EEG electrodes in your hair, you don't know when or if the patient is asleep.

The home sleep test is a good thing in that it will catch a large percentage of the patients with apnea at low cost. It also tests in the patient's real sleep environment. However, in my opinion, if the test results are somewhat borderline, the patient should have an in-lab PSG. Each version of home test has a different level of "gray" area results where further diagnoses and even an in-lab PSG should be done.

And all tests, PSG or in home, should be followed by monitoring by a full data CPAP, including airflow waveforms evaluated by a competent professional.
Get the free OSCAR CPAP software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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