Should You Do an At-home Sleep Test or a Lab Test?

September 26, 2024

Making the decision to test yourself for obstructive sleep apnea (OSA) can involve important decisions, one of which is where and how to get tested so you can obtain a diagnosis. Leaving this condition undiagnosed can poorly impact your quality of life and health overall, so it’s important to explore your options.

For some, lab-based polysomnography (PSG) tests aren’t as readily obtainable. Whether it’s due to location, wait times or even costs, a laboratory test conducted in a sleep clinic can pose significant issues for patients. This is exactly why home sleep apnea tests (HSAT) were developed. This revolutionary technology offers a much more affordable, easy-to-use and readily available option to help get your diagnosis moving. NSW CPAP takes things a step further in our Good Sleep Test by offering a comprehensive sleep test you can easily perform yourself in the comfort of your home and have your results reviewed by an Australian-based Sleep Respiratory Specialist.

Keep reading and discover the key factors you should consider when deciding between an at-home sleep test or traditional in-clinic appointment and make the right decision for your sleep health.

Accuracy – more than just numbers

Although the specific diagnostic numbers and percentages — things such as pulse rate or oxygen saturation that are measured in a sleep test are important for sleep technicians to consider, they’re not the only factor impacting accuracy. For many, having the test done in a familiar environment, like your home, makes a big difference. At-home tests allow you to stick to your regular routine, helping to produce potentially more realistic sleep data that better aligns or is more consistent with your typical baseline. This allows you and your healthcare professional to interpret the data with more insight into what your nightly events are truly like.

Studies show that these at-home tests give results that closely match those from lab-based polysomnography, especially for common conditions like OSA. With fewer wires and sensors than traditional lab tests, these devices monitor key aspects like breathing, heart rate, and oxygen levels without making you uncomfortable or encouraging you to adjust how you sleep to ensure you record a typical night’s sleep.

But what are the numbers?

Lab-based polysomnography is still considered the "gold standard" for diagnosing OSA, but at-home tests can also be highly accurate when used for the right patients. Portable devices used in HSAT focus on the most critical sleep parameters and have been shown to effectively diagnose OSA in many cases.

For example, at-home tests using advanced wearable technology can detect OSA with up to 88.5% accuracy and The Good Sleep Test has 94% Sensitivity for reliable detection of Apnea-Hypopnea Index (AHI). While they may not capture every detail like lab-based PSG, at-home devices can reliably identify the major issues related to sleep apnea.

The disadvantages

At-home sleep tests are convenient, but they aren't suitable for everyone. Here are some of the drawbacks:

Not for all patients: Home sleep tests are less suitable if you have more complex conditions such as central sleep apnea, heart disease, or neurological disorders.
Repeat testing may be needed: If your test is negative or inconclusive but symptoms persist, you may need to repeat the test or move to a lab-based study.
Limited data: At-home tests might not pick up on non-respiratory sleep disorders like restless leg syndrome or parasomnias.
Not ideal for certain conditions: Patients with severe insomnia, physical disabilities, or a high body mass index (BMI over 40) may not get accurate results from tests performed at home.

The advantages

Despite the minor limitations, the advantages of at-home sleep tests are significant. One of the biggest benefits is the comfort factor. For many, sleeping in a familiar environment can lead to more accurate readings because you’re more relaxed and less likely to have disrupted sleep as a result. This patient-preferred environment can be especially beneficial for those who experience anxiety in clinical settings.

Despite some of their limitations, at-home tests offer many benefits:

More comfort: Testing in your own bed helps you relax and can produce more natural results.
Readily available: For those in remote areas or with mobility issues, at-home tests provide a way to get tested without needing to travel to a sleep clinic.
Lower cost: At-home tests are usually more affordable than lab-based studies, which often involve overnight stays and specialist equipment.
More tests, faster results: Because at-home tests don't rely on lab capacity, there’s no waiting for a space to open up.

Who should use in-clinic tests?

You should consider a PSG test if:

You have a complex sleep disorder, such as central sleep apnea.
You are suspected of having non-respiratory sleep disorders, like sleepwalking or parasomnia.
You have other medical conditions, such as heart failure, chronic lung disease, or neuromuscular disorders.
You have had previous HSAT tests that were inconclusive or negative but still show symptoms of OSA.

Who should use at-home tests?

At-home sleep tests are a great option for many people, particularly those who suspect they have uncomplicated obstructive sleep apnea. They’re ideal for those wanting a convenient and less intrusive way to assess their sleep health. You might benefit from an at-home test if:

You’ve been having disrupted sleep and suspect OSA: At-home tests are highly effective for diagnosing common cases of OSA, where complex conditions aren’t suspected.
You live in a remote area: If travelling to a sleep lab is difficult due to distance or limited mobility, an at-home test can provide a reliable alternative.
You have a busy schedule: With an at-home test, there’s no need to take time off for an overnight stay at a sleep clinic. The test can be done in your own time, without disruption.
You prefer a more comfortable environment: Testing in familiar surroundings like your bedroom can result in more accurate, natural sleep patterns than those observed in a clinical setting.
You’re seeking a cost-effective option: At-home tests are more affordable than lab-based tests, making them a practical solution for those on a budget.

Tests such as the NSW CPAP Good Sleep Test are easy to use and allow you to collect essential sleep data without leaving your home. With minimal wires, an easy-to-use app and simple wrist and finger monitors, you can take the first step towards better sleep health without needing the referral of a doctor. However, it's generally recommended to consult a healthcare provider to ensure your health concerns are properly addressed and investigated to the fullest extent.

Choosing how to conduct your sleep test

There is no definitive right or wrong choice when deciding whether to opt for an at-home or lab-based test. For most people with uncomplicated obstructive sleep apnea, at-home tests provide a reliable, comfortable, and affordable option. However, for those with more complex conditions or unclear symptoms, a lab-based test might be more suitable.

In either case, it's important to discuss your symptoms and health history with a healthcare professional to choose the most appropriate test for your situation. Whether at home or in a lab, getting a diagnosis is the first step to better sleep and improved health.

At NSW CPAP, we are here to support you with a range of options to meet your needs—whether that’s through advanced at-home sleep testing or ongoing CPAP therapy. Our at-home solutions have helped countless people achieve quality and uninterrupted sleep, and we are confident you will too. If you have ever wondered whether a home-based sleep study is right for you, don't hesitate to reach out today to learn more or search for your nearest clinic.