What is a Home Sleep Test HST / HSAT?
A Home Sleep Test, or Home Sleep Apnea Test (HST/ HSATs), is an at-home sleep study option available to patients in specific circumstances. HSATs collect limited sleep data that can be analyzed and used to confirm a diagnosis of Obstructive Sleep Apnea. HSATs do not collect enough data to test for other possible sleep disorders and are only part of a comprehensive sleep evaluation. This does not mean an HSAT is less accurate than a Polysomnogram, just that they have different purposes.
Home Sleep Apnea Tests do not completely monitor sleep, as the abbreviation HST may suggest, but instead monitor breathing. This helps evaluate sleep-disordered breathing and symptoms such as gasping or snoring. Data from the home sleep apnea test device must be reviewed and interpreted by a board-certified sleep medicine physician. HSATs are an appealing, cost-effective option that allow patients to sleep in the comfort of their own bedroom. While there are many benefits to at-home sleep tests, they are not a fit for every patient.
Who is HSAT a good fit for?
Physicians can determine if an HSAT is the right choice based on medical history and examination. Doctors may recommend home sleep apnea testing if it is highly likely that the patient has moderate to severe obstructive sleep apnea and no other significant medical conditions. HSATs are often suggested for patients who are unable to have an in-lab study or sleep enough during one. HSATs also do not collect the same data-points, as HSATs only monitor breathing. For that reason, HSATs are only recommended for confirming a sleep apnea diagnosis.
When is HSAT not a good fit?
As mentioned, HSAT is only used to confirm the sleep disorder Obstructive Sleep Apnea. However, it cannot rule out Apnea if results are inconclusive. They are not recommended when sleep apnea is not highly likely, or if physicians suspect any other sleep disorder. If other sleep disorders are suspected or symptoms persist after an inconclusive HSAT, a Polysomnogram (in-lab study) is necessary for further sleep diagnostics. There are also certain medical conditions that HSATs are not recommended for, including having a BMI greater than or equal to 45, pulmonary diseases, neuromuscular diseases, congestive heart failure, and more. Discussing medical history with a physician is important to help them determine the appropriate type of sleep study to order.
What is a Polysomnogram/ In-Lab Study and Why is it Different?
An in-lab sleep study, also known as a polysomnogram, must be prescribed by a physician. This non-invasive testing requires an overnight stay in a sleep lab and offers the most complete evaluation of sleep. In-lab is more closely monitored than home sleep apnea testing and collects various data points. Heart rate, brain waves, breathing, eye movements, leg movements, muscle tension, and blood oxygen levels are recorded and measured. Data is then interpreted and provided to the referring physician. The physician then informs the patient of any sleep disorder diagnosis found through the study and prescribes a treatment plan.
Rather than only confirming or ruling out sleep apnea, in-lab sleep studies can help diagnose other sleep disorders. For instance, monitoring movement and muscle tension can help in the diagnosis of Periodic Limb Movement Disorder. If no other sleep disorder or medical condition is suspected, an HSAT may be prescribed as a convenient alternative.
Where to Get a Home Sleep Test?
Local independent sleep centers, national sleep testing providers, and hospital-based centers can all offer home sleep test options. All have various pros and cons, so you must evaluate which is best for your situation. Some personal elements to consider include insurance coverage and out of pocket cost, how far you are willing to drive to pick up a study, are you able to receive a machine delivery, and the level of customer service available to you. Advantage Sleep Centers are considered a local and independent option. To help you make an informed decision, we gathered pros and cons to compare Independent, Hospital, and National test providers.
National Home Sleep Test Providers
Pros
National HST Companies ship to home, patients use the test device, then send it back and wait for results. This method requires minimal interaction with anyone other than the physician, which some find to be easier and more efficient. There is also increased availability so that the test can be done on the patient’s own schedule. National providers allow a range of time to use the equipment before sending it back. National providers are also cost-effective due to competitive pricing. The ability to provide to a wider range of locations allows them to sell tests in higher quantities, lowering prices. It also means patients are not limited by a company’s proximity, leaving more provider options to choose from.
Cons
National Providers are purely diagnostic. They only work with data from studies then send results to the physician for all other sleep apnea support. National providers offer a method with minimal human interaction. Instruction is usually in the form of paperwork, online descriptions, or video. This makes it more difficult to have any questions answered during setup. Providing nationally means a higher quantity of callers to support lines, leading to longer wait times to speak with someone. It is also unclear who reviews the HSAT data. Data is sometimes auto scored or scored by out of state physicians when conducted nationally. Scoring by out-of-state physicians means a longer wait while obtaining out-of-state insurance authorizations.
Hospital Home Sleep Test Providers
Pros
Hospital Sleep Studies are conducted by licensed professionals. Results may become available faster because hospitals have more licensed sleep physicians to review data. The referring physician may also be affiliated with the hospital, which speeds up processes such as insurance authorization and results. Patients can speak to someone in person to troubleshoot issues and for treatment follow-up. If HST results are inconclusive, patients can have a polysomnogram conducted efficiently by sticking with the same provider.
Cons
The main downside to hospital studies is the price, charging up to triple the cost of other sleep study providers. They also have limited availability, long customer service wait times, and less focus on the patient as an individual due to high patient volumes. HST setup instruction is still not likely to be provided in person before you are given the equipment. Some hospital-based physicians are also incentivized to refer internally, and keeping with the same health system just due to physician recommendation could mean long travel times and waits for availability. It is important to know that referred physicians are recommendations; patients always have the right to find their own provider. Home sleep testing is not offered by all hospitals, and instead, the Polysomnogram is prescribed. Hospital polysomnographies can feel more clinical and uncomfortable for patients looking for a testing environment similar to at-home.
Local Independent Sleep Centers
Pros
Local, independent sleep centers can provide more affordable testing at up to 1/3 the price of a hospital-based sleep test. Local centers are more committed to customer service and full patient management throughout test setup, testing, and follow-ups on treatment. Full instruction on how to use the sleep test is available in-person. State-licensed and certified Sleep Techs work with physicians to ensure results are accurate and to help determine the treatment to suit individual Sleep Apnea needs. Data is reviewed and scored by an in-state licensed polysomnographer and reviewed with the referring physician before you receive results, which are read by local sleep medicine specialists. Local centers have more availability than hospital sleep centers, with availability 7 nights a week.
Cons
Independent and local centers may not be as convenient to schedule with as national providers. Local, independent centers focus on customer service and keeping patients informed, so services may not be for people who prefer automated or limited human interaction. Independent sleep centers are not affiliated with any hospitals or offices, so communicating results to physicians and then to patients can take a few weeks. As with all local sleep centers, patients may have fewer locations available based on distance and may have to drive further to pickup HSAT if delivery isn’t available.
What to Expect Scheduling with Advantage Sleep Centers
Advantage Sleep Centers are not affiliated with any hospitals or offices, yet most South Jersey physicians refer. We have a local reputation after providing sleep testing for 20 years. Our staff provides in-person instruction for HSAT set-ups and are available or in-person during business hours for support. We manage insurance authorization, referrals, and sleep-related inquiries for the patient and physician’s convenience, keeping all parties informed along the way. Advantage Sleep Centers has three convenient local facilities accredited with the American Academy of Sleep Medicine (AASM) and an additional HSAT setup options for patient convenience.
If a patient is prescribed an HSAT study by their physician, we schedule a day for the test. Patients visit one of our sleep centers to pick up the HSAT device, or the device is delivered, and the patient or their caregiver is given a thorough demonstration on how to use the machine properly. This education makes it easier for to set up the study at home. We are also available to support patients with any questions while setting up the HSAT. While the patient is asleep, all data is recorded on the device. That data is then reviewed by licensed sleep technicians and the patient’s physician before results are returned to the patient 2-3 weeks after the study.
To schedule an appointment with Advantage Sleep Centers or learn more about our services, call 856-95-SLEEP or choose one of the options below: