The conventional global standard for diagnosing OSA was in-lab polysomnography (PSG). Home sleep tests (HSTs) can, however, be used to evaluate this issue in the right patient. The same breathing apparatus, pulse oximetry devices, and motion and positional sensors are used in both PSG and HSTs. The results of each test are examined in the same way. Several investigations have found a strong link between the outcomes of multichannel HSTs and PSGs.

Even so, an observed sleep study is necessary if a patient is unable to follow the directions for home sleep testing owing to age or cognitive problems.

An Overview of Home Sleep Study Tests 

The necessity for, and relevance of, a HST, according to health professionals, should be premised on the health history of an individual and consultation by a healthcare professional, either personally or through telemedicine. A HST is a clinical diagnosis that must be instructed by a physician to diagnose OSA or assess the efficacy of the treatment. It should never be used for general screening of undiagnosed people.

A HST has the benefit of being a portable sleep apnea device allowing monitoring to take place in the patient’s own home with minimal equipment, resulting in a more relaxed sleeping environment. In addition, sleep apnea diagnostic devices are far less costly and more generally available than PSGs used in facilities.  They can be used to diagnose OSA and titrate positive airway pressure (PAP) therapy at home. There are also no reported complications related to sleep testing at home.

HSTs however have a limited capacity to quickly identify and address operational faults, as well as the incapability to detect various forms of sleep disorders and greater involvement for the patient in terms of device installation and use, which may make some patients uneasy.

Furthermore, because sleep and waking states are not directly examined, the complete sleep duration cannot be estimated from a HST recording. Inadequately prepping the patient for HST or misplacing the equipment can result in unclear findings or erroneous readings, just as they might with PSG. However, with a portable sleep apnea device, there is usually no attendant available to resolve these difficulties as they emerge, so the individual may have to redo the study.

Levels of HST Devices

There are four levels of sleep apnea diagnostic devices available; Level 1 through Level 4. They include:

Level 1 

A level I sleep test involves the continuous and simultaneous monitoring and recording of numerous physiological and pathophysiological sleep characteristics, as well as physician assessment, analysis, and reporting. It is performed in a medical institution and is usually composed of a lead electroencephalogram (EEG), electrooculogram (EOG), submental electromyogram (EMG), and electrocardiogram (ECG). It should additionally measure and record the following sleep-related characteristics:

• Flow of air
• Breathing effort
• Oxygen saturation by oximetry
• Can be done as an entire night of monitoring for diagnosis alone or as a split overnight study for diagnosis and therapy evaluation.

Level 2

A level 2 sleep study is typically conducted in the comfort of one’s home but some level 2 sleep studies may be done in a sleep lab or sleep clinic. A level 2 sleep study examines cerebral and muscle movement in addition to respiratory activity, oxygen saturation, and heart rate. A level 2 sleep study is so effective it can track leg and body movement, detect periodic limb movement disorder (PLMD), and give a more in-depth examination of the overall length and quality of your sleep.

Level  3

A Level 3 Sleep Study, commonly known as a portable monitoring device or HSAT, can be used to identify obstructive sleep apnea (OSA). Many people prefer this strategy if they don’t have serious symptoms and can do the test on their own at home. If one suspects they have moderate to severe sleep apnea, it’s typically preferable to have a full sleep study done in a lab to provide the most precise findings, as portable monitors tend to underestimate the severity of OSA when contrasted to a sleep test done in a lab.

Level 3 Sleep Studies, which measure oxygen saturation, heart rate, airflow, and exertion while also collecting data about snoring, are now a more useful and available technique to confirm OSA.  One utilizes a sleep kit at home to record the respiratory activities, oxygen saturation, and heart rate throughout the night with a level 3 sleep study. A level 3 sleep study measures both snoring and airflow and determines whether you have obstructive sleep apnea.

Level 4

Level IV devices are used to monitor only one or two parameters, for example, oxygen levels or airflow, and they usually contain oximetry, but not just oximetry. As the technology continues to advance, however, modern devices have at least three channels.

Conclusion

Sleep apnea diagnostic devices use a varied number of channels to evaluate respiratory measurements, oxygen levels, pulse rate, chest, and abdominal movement and snoring.

Nose prongs, similar to those used to administer nasal oxygen, are commonly employed to measure airflow. An oral thermistor may be used to detect mouth breathing, and a sensor measures pressure changes. For the majority of HSTs, a pulse oximeter is placed on a finger or earlobe to measure oxygen saturation. A single-lead ECG with an electrode placed to the upper chest can be used to measure heart rate.

Snoring may be detected with a microphone worn around the neck. Respiratory effort is measured using chest and abdominal belts, which helps to distinguish between central and obstructive apneic episodes.

The total absence of movement of either belt is considered a central apneic episode. An obstructive apneic episode, on the other hand, is defined as paradoxical movement during breathing, such as belly expansion during inhalation but no chest expansion.

A bad night’s sleep can be caused by a variety of reasons. These include taking caffeine right before bedtime, working late, too much noise, extreme tiredness, and many other reasons. Then there is sleep apnea, which causes more than just a few nights of poor sleep. One may find themselves wondering, what is sleep apnea?

In layman’s terms, sleep apnea is a condition in which a person’s breathing is regularly interrupted while sleeping. Apnea can disrupt sleep up to thirty times in an hour for some people, which can be very discomforting. The brain then sends signals and wakes one up, usually with a bodily jerk or a gasp for air. These nightly disruptions in sleep can have a significant impact on your general health.

We are all aware that insufficient sleep may have a negative influence on a person’s mental and physical health. Constant exhaustion due to sleeplessness makes it hard to focus and get tasks done.

Sleep apnea is far more widespread than people realize. According to the research, sleep apnea affects up to 20% of the population, and about 80% of people with sleep apnea are oblivious that they have it. This might be because the symptoms of sleep apnea are so common.

When the usual risk factors or indicators of sleep apnea, such as obesity and heavy snoring, are lacking, diagnosing sleep apnea can be very difficult. The majority of people seek professional help when their snoring is disturbing somebody else’s sleep, such as a bed partner or roommates.

However, snoring is not the only symptom of sleep apnea. Other indications include fatigue even after hours of sleep,  having a dry mouth early in the morning, a sore throat and headaches on waking up, and daytime drowsiness.

Diagnosing Sleep Apnea

The diagnosis of sleep apnea is done by a medical practitioner who will examine the genetic history, signs, and any health problems that may cause sleep apnea. The physician may examine the neck, jaw size, tongue, lungs, heart, and neurological systems for signs of sleep apnea issues.

They may order a sleep study, also known as polysomnography, after the clinical examination to identify sleep apnea.  During the sleep study, a sleep technician monitors patients’ blood oxygen levels, brain activity, heartbeat, and respiration as they sleep in a sleep lab.

Doctors may do an endoscopy after a sleep apnea diagnosis to determine the location of the airway obstructions.

Some specialists may prescribe a home test instead of a lab test because it is more convenient. A home sleep apnea diagnosis is not as precise as those done in the lab because it just assesses breathing. Home testing is not the best for people with respiratory illnesses, cardiac problems, respiratory distress, restless leg syndrome, or central sleep apnea.

Causes of Sleep Apnea

When awake, throat muscles maintain the firmness and openness of the airway so air can flow into the lungs. These muscles get more relaxed while we sleep. Usually, the airway remains open to enable airflow into the lungs regardless of the relaxed throat muscles. Your airway might be closed or constricted during sleep if you have sleep apnea. The airway may be obstructed for multiple reasons:

• The chest muscles and tongue relaxing more
• Obesity can result in the addition of fat tissue in the body that can thicken the wall of the windpipe, narrowing its opening.
• The structure of the head and neck may cause a narrower airway between the throat and mouth.
• Smoking is substantially more likely to cause obstructive sleep apnea. It causes inflammation and fluid accumulation in the upper airway
• Congestion in the nose. You’re more prone to develop obstructive sleep apnea if you have trouble breathing via your nose, whether due to anatomic issues or allergies.
• Medical problems. Conditions such as heart problems, hypertension, high blood sugar, asthma, and Parkinson’s disease can all raise the risk of obstructive sleep apnea.
• Growing old increases the risk of both obstructive and central sleep apneas.
• Men are up to three times more likely compared to women to suffer from sleep apnea. Women, on the other hand, are at higher risk if they are obese.

Types of Sleep Apnea

Whenever the question, “What is sleep apnea?” is raised, it cannot be conclusively defined without mentioning the types of sleep apnea. There are three common types of apnea. They include obstructive sleep apnea, central sleep apnea, and complex sleep apnea.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is the most widespread kind of sleep apnea. The muscles at the back of the throat, which usually relax during sleep, collapse so much in those with OSA, limiting proper airflow. The soft tissues in the back of the throat, including the soft palate, uvula, tonsils, and tongue, are supported by the throat muscles, so when those muscles relax too much, those tissues can drop back into the throat, partially or fully restricting the normal passage of air in the airway.

When the airway is partially closed, a person often begins to snore, which is a typical symptom of OSA. Simply defined, obstructive sleep apnea occurs when there is insufficient air in your lungs throughout the night, and your brain wakes you up to breathe.

Central Sleep Apnea

Central sleep apnea is less common than OSA. It is also more difficult to identify and cure. Central sleep apnea occurs when the brain does not deliver the necessary signals to muscles that coordinate breathing, unlike obstructive sleep apnea, which is caused by a  condition that restricts the airway.

Central sleep apnea is caused by a neurological condition. While central and obstructive sleep apneas share many signs, such as breathing interruptions, frequent awakenings throughout the period of sleep, and daytime drowsiness, central sleep apnea frequently affects individuals who have chronic underlying conditions.

Complex Sleep Apnea

It is the result of a combination of obstructive and central sleep apnea. This kind of sleep apnea may appear to be obstructive sleep apnea at first examination. However, unlike normal obstructive sleep apnea individuals, the symptoms of these patients are not entirely addressed by the use of a continuous positive airway pressure machine(CPAP).

Because CPAP is normally very effective in treating obstructive sleep apnea, the patient’s inability to improve could indicate central sleep apnea. Breathing issues remain in people with complex sleep apnea syndrome even when the airway blockage is addressed and treated, indicating that something other than collapsing throat muscles is contributing to the apnea.

Conclusion

After diagnosing sleep apnea, the doctor may prescribe the use of treatment devices, therapies, or even a surgical procedure to open up the airway in moderate to severe conditions.

Continuous positive airway pressure (CPAP), in which a machine distributes constant air pressure through a mask into the nose or mouth, or a mouthpiece intended to keep a patient’s throat open, are common treatments.

In mild cases where patients are having trouble sleeping, the doctor may recommend lifestyle adjustments such as regularly engaging in various physical exercises, but not doing so shortly before bedtime, as this can stimulate adrenaline and keep the patient awake.

Also, reduction of alcohol consumption may help as too much indulgence may disrupt sleep. Caffeine should be avoided before going to bed and development of a sleep ritual that includes taking a warm bath, decreasing the lights, and drinking herbal tea could help.

Over a couple of years, sleep treatments have grown in popularity. Sleep disorders are becoming more common, and sleep centers are springing up in clinics and major hospital settings to fulfill the rising demand for sleep medicine.

The diagnosis and treatment of sleep apnea are guided by fact-based recommendations in sleep medicine. However, there are insufficient sleep centers and caregivers in this area. There have been numerous advancements in the recording of sleep and the diagnosis of sleep disorders. Many sleep disorders are so chronic that they make it necessary to undergo constant treatment and evaluation. It is critical to use cost-effective technology for initial diagnostic and therapy monitoring, and sleep apnea home monitoring devices are a reasonable option.

Sleep apnea is a common condition that many people experience, and anyone can go through it. For people who fear they may have sleep apnea, a home sleep study is a good alternative to aid in diagnosis.

What Exactly is Sleep Apnea?

Sleep apnea is a condition in which a blocked airway causes someone to stop breathing periodically while sleeping. There are many possible explanations for this problem; however, therapies are generally constant and highly successful regardless of the cause.

Obstructive sleep apnea (OSA) can be diagnosed with an at-home sleep apnea test. Home sleep apnea testing, as the name implies, is performed in the privacy of a patient’s own home. The majority of sleep apnea home monitoring devices are small enough to fit in the palm of a hand. To correctly complete the test, you can use a variety of devices. A sleep specialist helps get the equipment that a patient needs.

Why Do a Home Sleep Test? 

There are a number of benefits to doing home sleep tests. Consultation with a sleep technician determines whether a sleep apnea monitor at home is the best solution. As it can be conducted at home, home sleep testing is notably the most favorable diagnosis option. Sleep apnea testing done at home saves time and effort.

Additionally, there is a lot more equipment involved in lab tests.  At-home sleep apnea tests are more cost-effective and reasonable because there is less equipment required and no requirement for a sleep technician. It involves the use of simple devices that aren’t too invasive to your body.

Home sleep studies, however, do not collect as much information as those conducted in a lab. They are mostly only for obstructive sleep apnea. When the doctor finds that the data collected is not enough, they may recommend another study done in the lab.

Data Collected by Home Sleep Study

Several factors are assessed during a home sleep apnea test or a home sleep test to determine if one has obstructive sleep apnea. The aspects that are measured, as well as the sleep apnea diagnostic devices that assist in data collection, are listed below.

• Airflow in the nose and mouth: This is used to record your airflow throughout the night. A small wire is placed in the nose and mouth. Some sensors resemble that of an oxygen cannula.
• Measurements on the breathing effort are captured using elastic belt straps put over the chest and belly.
• Levels of oxygen are collected by an oximeter finger probe. This is a  clip-like sensor attached to the finger that produces a red light to help measure oxygen concentration in the blood while asleep.

Home Sleep Study Procedure

When one understands what the at-home sleep apnea test comprises and how it operates, it’s a fairly simple process. While each home sleep test service has its own set of guidelines, there is a common approach that one should follow.

• Consult a doctor to determine if a study is appropriate for you. It is also good to find out from the doctor the best sleep apnea diagnostic devices to use. There is a lot of information online, and not all of it is correct.  If it is, your doctor will instruct you to do an at-home sleep apnea test.
• The equipment is usually brought to the patient’s home or picked up from the doctor’s office. It is then put to use once it has been received.
• The study should be done for about three nights to collect sufficient data for the sleep technician to evaluate.
• The devices are then returned for assessment.
• The sleep technician retrieves and analyzes the sleep data before generating a report. The conclusions drawn from the report are what the doctor uses to make recommendations and a treatment protocol.

Physiological Sensors

Modern sleep home monitoring devices consist of wireless physiological recorders that collect about three nights of data. One of these devices gives the amount of oxygen in the blood.

Pulse rate, ventilation, snoring severity, head posture, and head movement are all factors that can now be accurately recorded using a sleep apnea monitor at home. This provides a detailed depiction of a patient’s breathing patterns while sleeping at home, regardless of the patient’s sleeping position.

Some gadgets also have audible and visual signals that inform the user of whether any adjustments are needed. They are non-invasive and user-friendly.

Current technology can also track peripheral arterial tone and activity, as well as the concentration of oxygen in the blood. Obstructive sleep apnea can now be detected just as well as using lab study equipment.

Conclusion

Home sleep studies will become more popular with technological advancement. With the increased accuracy of diagnosis, coupled with other reasons such as comfort, patients prefer home sleep monitoring. In addition, most patients prefer the privacy that can be offered by home sleep apnea diagnostic devices. It stands to reason that this is what a lot of patients will go for in the future.