Why Is It Good to Do the Sleep Test at Home?
By Patty - Certified Polysomnographic Technician
The Dangers of Undiagnosed Sleep Apnea
This article will review the different types of sleep studies as well as the WatchPat One disposable home sleep study device. You will learn about an OSA diagnosis (Obstructive Sleep Apnea) and how it affects the sleeper.
Always discuss any health symptoms with your doctor and receive medical direction if you suspect you have OSA.
If you or your sleep partner are wondering if you need a sleep study, please consider the following symptoms:
- waking up gasping or choking in the night
- extreme daytime tiredness (falling asleep while driving or even at work).
Sleepers of the male gender, over 50 years of age, with a BMI greater than 35 and a neck circumference over 16 inches, are at risk of having OSA. Please keep in mind that sleepers of the female gender with a healthy BMI may have OSA, as well.
These are high probability symptoms only, and a sleeper with OSA need not have them all or even any - it all comes down to if you breathe consistently during sleep.
It is often the partner who observes the sleeper when they stop breathing and choking or gasping in the night. The sleep partner is also the one who sees the daytime tiredness, lack of energy, and mood changes, as well. These symptoms lead sleepers to do more research or seek medical advice.
Unseen symptoms of untreated Obstructive Sleep Apnea define the seriousness of the diagnosis. Sleepers with untreated OSA are at risk for cardiovascular and metabolic health issues, such as heart attacks, strokes, diabetes, high blood pressure, and obesity.
Sleepers with untreated OSA are more likely to be in a car accident and to have marital issues. Sleep partners are also affected as the sleeper with OSA not only suffers from disruptive sleep but also causes the partner to have disruptive sleep. OSA left untreated has long term consequences.
Obstructive Sleep Apnea
Obstructive Sleep Apnea is, by definition, when a sleeper has repeated apnea events during sleep. An apnea event occurs when the upper airway of the sleeper is obstructed and reduces or blocks the airflow during sleep for longer than 10 seconds and causes a significant drop in the blood oxygen level.
The upper airway of the sleeper can collapse for many reasons. When this occurs, it causes a blockage in the airway, or an apnea.
When an apnea occurs, the person becomes unable to breathe. The brain then signals the heart to get busy circulating the oxygenated blood throughout the body. Eventually, the brain takes over and forces the sleeper to wake, making the sleeper choke and gasp and then go back to sleep.
The sleeper’s apneas never allow the sleeper to enter, or stay in, the deep, restorative stages of sleep required for the human body to stay healthy. The cardiovascular system is overworked, organs are not allowed time to heal or produce, the brain is never able to rest and suffers from lack of oxygen intermittently all night long.
Types of Sleep Studies
There are different types of Sleep Studies approved by the AASM - American Academy of Sleep Medicine - aimed at diagnosing sleep apnea and other sleep disorders.
A PSG or Polysomnography is completed in a sleep lab and attended by a sleep technician. This is called a Level 1 sleep study and is the gold standard in OSA diagnostics.
A PSG that is not attended by a sleep technologist but still measures the brain waves is called a level 2 sleep study – these are uncommon.
A home sleep study is called a Level 3 or Level 4 sleep study, depending on the type of measurements they are monitoring – these are the most common type of sleep test these days. Sleep studies are non-invasive and painless.
During a sleep study, the number of apneas per hour is tracked. Your diagnosis is related, directly, to how many times the sleeper stops breathing each hour. Every person will have apneas at some point throughout the night.
It is considered to be within normal ranges up to a maximum of 5 times an hour.
A person diagnosed with mild OSA will have 5 – 15 apneas/hour; moderate OSA – 15-30/hour; and severe OSA is greater than 30 times per hour.
Data collected during a Level 1 Sleep Study includes:
- Body movement
- Body positioning
- Chest movement
- Heart rate
- Oxygen saturation
- Brain waves
- Eye movement
- Number of apneas and types of apneas.
The Registered Polysomnographic Technologist will note the events on the data recording and send it to the interpreting doctor who is then able to make an appropriate diagnosis from the compiled data.
A Level 1 Sleep Study takes place in a sleep lab. The sleeper goes to the lab and sleeps there overnight. The sleeper has electrodes connected on their head and body to enable monitoring of the sleep stages and cycles.
In the morning, the sleeper leaves. The data is read by the Registered Polysomnographic Sleep Technician, and a diagnosis is completed by the Sleep Doctor.
Level 1 Sleep Study - Pros
The primary benefits of the Level 1 PSG are that a sleeper may be able to have a split night study and be titrated for CPAP pressure, as well, depending on the severity of their apneas and what the doctor has ordered.
The Level 1 PSG is also more accurate when ruling out sleep apnea and can account for all the time when the patient is awake and remove it from consideration. This helps make sure that the severity of the apneas is not underestimated by including wake time in the apnea index calculations.
Level 1 Sleep Study - Cons
The primary drawbacks of the Level 1 PSG are that a referral is required by your doctor to attend a sleep study, and there may be a wait list. It can be a lengthy wait before you get results, as well.
The sleeper may need to attend a second night for the CPAP titration to be completed. Another drawback is that it can be a rather uncomfortable night trying to sleep in the hospital with so many devices attached to you.
Home Sleep Study - Pros
The sleeper receives the device to use in their own home. Following the instructions, the sleeper will hook up the device and sleep in their own bed while the data is collected.
The primary benefits of the home sleep test include sleeping in the comfort of your own home, fewer devices attached to you, no need for a referral, and a fast turnaround for a diagnosis.
Home Sleep Study - Cons
The primary drawback of this test is that it can underestimate your apnea index as it does not monitor your brain waves to track when you are awake. This makes it an excellent test for ruling in sleep apnea, but not a great test to rule it out.
The “normal” results will usually just inspire further investigation for highly symptomatic patients – usually leading to the Level 1 PSG.
The sleeper receives the watch and the instructions. The sleeper downloads an application on their smartphone which wirelessly collects the sleep data.
The watch, finger pulse oximeter, and chest probe collect the data, including body movement, snoring, body positioning, chest movement, heart rate, and oxygen saturation.
The instructional video and 24/7 support provide the sleeper with the confidence to complete the sleep study successfully. The device is disposable and unique to your single use only.
Most Level 1 PSGs do not include titration, and an Auto CPAP is recommended. This is the same for the home sleep study as the Auto CPAP will adapt the pressure required for the sleeper to be optimally treated.
If you have been using CPAP therapy for many years and need a prescription for the purchase of a new CPAP, the WatchPat is a quick solution. Your OSA diagnosis will be confirmed in the comfort of your own home, and you will have the full study report in one week’s time.
If you suspect that you may have sleep apnea, the WatchPat is a quick solution. With one night’s sleep in your own bed, you will know if you have OSA or if the test has come back within normal ranges.
If the test comes back within normal ranges, you will receive the study to share with your doctor for next steps on the symptoms you are having. These next steps may include a referral for a Level 1 PSG.
The home sleep tests do tend to underestimate the number of apneas you have each hour because they cannot subtract the time you are awake from the calculations as they do not track the brain waves.
If the test shows that you do have sleep apnea, the sleep study result recommendations will include your prescription for the purchase of the CPAP you require.
Traditionally, snoring has been a decidedly comical act or a bone of contention between sleep partners. Basically, snoring has been accepted as what some sleepers do in their sleep.
Now you know there may be more to snoring than that. If you are reading this article, you or your sleep partner or someone you care about must be showing some signs and symptoms of OSA.
A sleep study is the first step in addressing the sleeper’s symptoms if they wish to know for sure if they have sleep apnea. If the sleeper does have OSA, then CPAP therapy will be introduced into their life.
If the sleeper does not have OSA, then it can be ruled out as the cause for whatever symptoms the sleeper may be noting. The test results will help both the sleeper and the doctor take care of the sleeper’s health either way.
Knowledge is power. OSA is a serious diagnosis with a simple treatment. CPAP Therapy - Continuous Positive Air Pressure - is the gold standard therapy for OSA diagnosis.
CPAP keeps the sleeper’s airway from collapsing, preventing nocturnal apneas. The CPAP machine blows positive air pressure into the sleeper’s airway through an interface. It is simple and convenient.
The sleeper is going to sleep every night already so no need to make time for therapy. This can be life altering. Sleepers’ lives change dramatically once their OSA is under control. The body, brain, and organs all rejuvenate with proper sleep achieved under CPAP therapy. Livelihoods return to sleepers who use CPAP therapy. The sleeper’s daytime energy, improved mood, weight loss, and overall health improvement are noted almost immediately. Often it takes consistent CPAP therapy results before the sleeper really understands just how poorly they were feeling.
You now have the facts on the different sleep studies and the WatchPat One Home Sleep Study, as well as the benefits and drawbacks to each type of test. You now know how sleep apnea affects the body.
We have reviewed the symptoms of sleep apnea and how it affects a sleeper if left untreated. And we reviewed briefly how CPAP therapy cares for OSA. The only way to know for sure if you have Obstructive Sleep Apnea is by completing a sleep study. Please remember to always discuss any of your health concerns with your doctor.