Sleep Apnea Testing Explained

The Process, Cost, and Options for Diagnosing Obstructive Sleep Apnea

While you may be wondering how to get diagnosed with obstructive sleep apnea (OSA), many who suffer from this sleep disorder may not even know that they have it. Over 85% of OSA sufferers go undiagnosed because the side effects of untreated sleep apnea seem fairly benign.

Symptoms Of Sleep Apnea

Nighttime Symptoms

    • Loud, persistent snoring
    • Witnessed pauses in breathing (often from a family member or significant other)
    • Choking or gasping for air during sleep
    • Restless sleep
    • Frequent visits to the bathroom

Daytime Symptoms

    • Early morning headaches
    • Excessive daytime fatigue or drowsiness
    • Poor concentration
    • Depression, irritability, or mood swings
    • Sleepiness during routine activities (e.g. driving)

If you or someone you love is suffering from these common side effects, it is imperative to have a sleep study done soon. Untreated sleep apnea can lead to alarming medical conditions if left untreated, like high blood pressure, heart failure, Type 2 diabetes, and even cancer. 

Statistics Of Sleep Apnea

Sleep apnea is a pervasive sleep disorder that affects a large part of the U.S. population. At present, there are 326 million people in the U.S. Of these 326 million: 

  • 10% suffer from mild OSA
  • 3.5% suffer from moderate OSA
  • 4% have severe OSA.

The problem with only reviewing diagnosed cases is that an alarming 75-80% of cases remained unidentified. (1) 25% of individuals with moderate obstructive sleep apnea have neither subjective nor objective sleepiness. (2)

Sleep Apnea Statistics by Age & Gender

There is really no way to identify who is or is not at risk for OSA based on age or gender. 26% of adults aged 30-70 years have obstructive sleep apnea (3). And this includes children, adults, the elderly, men, and women. About 20% of children snore, but 1-4% of children aged between 2-8 suffer from obstructive sleep apnea (4-5)

While OSA impacts all genders equally, sleep-disordered breathing affect  23.4% of women and 49.7% of men (6). Which is a male-to-female ratio of 2 to 3:1 (7). Men are more likely to suffer from sleep apnea, but only by a small margin. 

Sleep Apnea Risk Factors Statistics

Obstructive sleep apnea is associated with obesity in more than 60% of cases.(8) But obesity is only one of several potential risk factors. Others to be aware of are a narrowed airway, high blood pressure, chronic nasal congestion, or smoking. 

If you are suffering from OSA, it is imperative that you seek testing and treatment as soon as possible. If left untreated, obstructive sleep apnea increases the risk of (9): heart failure by 140%, stroke by 60%, and coronary heart disease by 30%. 

Another factor to be aware of is Type 2 Diabetes. Up to 83% of patients with type 2 diabetes suffer from unrecognized sleep apnea (10). But Diabetes is not the only disease that can indicate undiagnosed OSA. ALS patients are more likely to have sleep apnea than the general population. 45.6% of ALS patients had more than five apneas or hypopneas per hour. (11)

Improved Quality of Life with CPAP 

While the idea of sleeping with a CPAP may be worrisome for many, the benefits of CPAP therapy far, far outweigh the drawbacks. The quality of life in sleep apnea was better after CPAP therapy than from baseline, according to Calgary Sleep Apnea Quality of Life Index. The SAQLI is a useful tool to evaluate the quality of life in sleep apnea, especially to highlight the benefits of CPAP therapy, even with short time monitoring.

After receiving CPAP therapy for only three months, individuals reported an improvement in daily functioning, social interactions, emotional functioning, symptoms, and their SAQLI baseline. (12)

Diagnosis For Sleep Apnea

Sleep apnea does require a diagnosis from a board-certified sleep physician or one of the other approved medical professionals. Other approved medical professionals include: 

  • Dentists
  • Cardiologists
  • Pulmonologists
  • Neurologists
  • ENTs
  • Psychiatrists
  • Primary Care Physicians

Many people may be at risk for OSA, and there are only a few surefire ways to ensure you are getting a reliable diagnosis. Be sure to talk to your doctor or speak to a Good Sleep representative about your options for testing. 

How To Diagnose or Get Diagnosed With Sleep Apnea

In order to be diagnosed with sleep apnea you must undergo a sleep study and have the results and diagnosis confirmed by a board-certified sleep physician. Like many disorders that require long-term treatment, a sleep apnea diagnosis qualifies you to receive a variety of sleep apnea treatments like CPAP, AutoPAP, BiPAP, or even surgery and dental appliances. 

Diagnosing Sleep Apnea At Home

Getting a sleep apnea diagnosis does not need to be a stressful experience. You should always make regular visits to your doctor, but, if they want you to get tested for sleep apnea, they will just refer you to a sleep lab or a home sleep test provider. Rather than jumping through costly, drawn-out hoops, you are able to diagnose your sleep apnea at home with a home sleep testing kit. 

Most at-home sleep testing kits do not even required a referral. You can take our patient questionnaire to see if you are a good candidate for sleep testing, and receive your kit in as few as 2-3 business days. Don’t wait because your home sleep testing kit is the first step to a better night’s sleep and a better quality of life. 

What Is A Test For Sleep Apnea?

Types Of Sleep Apnea Tests

Essentially, a sleep apnea test is a study that measures your vitals during sleep. There are a few different ways to test for these vitals, so you and your doctor need to decide which of these options is best for your particular needs. 

There are two basic forms of sleep testing: at-home sleep tests or in-lab sleep studies. Both of these options will vary in scheduling, time commitment, cost, and severity of potential disorder. 

Home Sleep Apnea Tests

A home sleep test is an overnight unattended sleep study that is performed in the comfort of your own home, in your own bed. After receiving your Home Sleep Test (HST) device and activating the recording session, the device will monitor a series of biometric data while you sleepbreathing patterns, blood oxygen saturation, heart rhythms, respiratory effort, sleep positions, and more. After you mail the device back to your HST administrator, a board-certified sleep physician will interpret your results, giving you a diagnosis and, if necessary, a prescription for a treatment machine. Please note, that HSTs are only approved for adults 18 years and older and are frequently limited to only testing for Obstructive Sleep Apnea (OSA). 

Polysomnography

Commonly referred to as an in-lab sleep test, Polysomnography is used to diagnose a variety of sleep disorders by recording your brain waves, blood oxygen levels, heart rate, breathing, and eye and leg movements during sleep. These tests happen in hospitals or other on-site sleep labs. You will spend the night in a sleep lab room, which frequently looks like a normal bedroom, You will wear a series of sensors from your head to your legs in order to collect the series of data mentioned above. Results take a few weeks. While this test is usually too long, uncomfortable, and detailed to be necessary for those with sleep apnea, polysomnography is vital to those suffering from insomnia, narcolepsy, and restless leg syndrome (RLS).

Equipment Involved In A Sleep Apnea Test

Your HST will come with a few pieces of sleep apnea test equipment you will be able to easily wear and activate: 

  • Portable sleep data monitor
  • Chest strap
  • Heart rate sensor
  • Nasal cannula 

All of this will come with detailed instructions on how to operate the machinery so your results are accurate and not impacted by user error. 

Risks Involved With Sleep Apnea Tests

With in-lab testing, constant monitoring by health professionals ensures you are in no way at risk during the sleep test. There are few to no risks associated with sleep apnea testing.  

At-home sleep tests happen from the comfort of your own home, and risks are limited to user error when setting up the home sleep test unit. There are detailed instructions which teach you how to properly set up the machine so user error risks are very mitigated. If the data collected from your home sleep test is not clear or usable, then there is a possibility of needing to retake the home sleep test. 

Sleep Apnea Test Cost & Insurance

Without insurance, the cost a home sleep apnea test can vary between $150 and $500 depending on your testing provider. You’ll want to do lots of research to ensure you are using a reliable provider who will get you the results you need. 

Does Medicare And/Or Insurance Cover Sleep Apnea Testing?

Home sleep testing is often covered by most insurance companies if the patient exhibits likely symptoms for sleep apnea and qualifies for “medical necessity.”  Sleep apnea testing is covered by Medicare as well as insurance companies like Blue Cross/Blue Shield, Aetna, and Cigna. Be sure to check with your insurance provider before ordering your sleep test. 

While insurance does typically cover testing and, occasionally, treatments, Good Sleep does not work with insurances directly. This is actually beneficial to the patient because it means you can receive your testing sooner and, oftentimes, for cheaper. 

Paying Good Sleep out-of-pocket does not mean your insurance won’t reimburse you. However, you will have to do some research to see if your insurance has processes in place for out-of-pocket medical purchases. Check out our blog post for more information on billing your insurance directly.

Cost Of Sleep Apnea Test Without Insurance

The difference between insurance coverage and self pay varies. If you are uninsured, there are many some sleep test providers who will accept out of pocket payments for both the sleep apnea test as well as the necessary medical therapies if you should receive an apnea diagnosis. 

As opposed to at-home sleep tests, in-lab sleep studies can run between $1000 and $3000, which is why they are not always recommended for those who believe they are a likely sufferer of sleep apnea as opposed to more complex sleep disorders. 

While insurance might be the more familiar option, that doesn’t mean it is the best option. By going the self-pay route, you are putting yourself in control of your health and wellness decisions. With Good Sleep, you can ensure you are getting step-by-step support and getting the testing and treatment you need without insurance interference. 

Sleep Apnea Test Questionnaire To Take Now

Many providers will start the process by having you fill out a patient questionnaire. This a quick and easy process that will give your provider insight into your medical history and if a home sleep test is right for you. 

How To Get A Sleep Apnea Test

Where Can I Get A Sleep Apnea Test?

Ordering your home sleep test is simple and easy. You’ll reach an online ordering page where you can easily add a sleep study to your cart from your computer, tablet, phone, and most other internet-enabled devices. Once you add the test, you will choose from a variety of shipping options and enter in your shipping information. 

Then, pay the cost of the test and shipping with your credit or debit card information. Your sleep testing unit will then be sent to your provided address once check out and processing is complete. 

Your home test kit comes with a few pieces of equipment you can easily wear and activate, including a portable sleep data monitor, a chest strap, a heart rate sensor, and a nasal cannula. 

How To Get Tested For Sleep Apnea

In order to see if you are suffering from OSA, you need to undergo a sleep test. There are two basic forms of sleep testing: an at- home test and an in-lab study. You will need to talk to your doctor about the best ways to go about qualifying for these tests so you can start the process sooner rather than later. 

Sleep Apnea Test Kit By Mail

If you choose to go with a home testing provider, like Good Sleep, you will receive your home sleep testing kit by mail. The process is very simple: 

  • Order a Home Sleep Test unit
  • Check out with a debit card, credit card, or PayPal
  • Choose your shipping method
  • Complete your order

Based on the shipping method you choose, your home sleep test will arrive between 1 and 14 business days. Once you have your test in hand, you can start the OSA (Sleep Apnea) testing process. 

Sleep Apnea Test Process & What To Expect

How Does A Sleep Apnea Test Work?

Your HST will come with a few pieces of equipment you will be able to easily wear and activate, including a portable sleep data monitor, a chest strap, a heart rate sensor, and a nasal cannula. You will also be provided with detailed instructions that will outline how to properly position all of these parts and how to activate your monitor to record your sleep behaviors. All of this together will result in a successful sleep test and collect appropriate data for a diagnosis. 

Sleep Apnea Test FAQs

Is a Home Sleep Test Uncomfortable or Painful?

While all sleep studies can come with some level of discomfort, home sleep tests are far more comfortable and convenient than in-lab sleep studiesnot to mention far cheaper in most cases, even with insurance. Rather than going to a sleep lab or hospital and trying to sleep in unfamiliar surroundings, HSTs allow you to sleep in your bed, at home, while still having your biometric data monitored. The device is small and relatively uncomplicated and you should be able to sleep normally while wearing it. 

How Long Do I Have to Be Asleep?

We advise that, when undergoing your HST, you stick to your normal bedtime routine. You shouldn’t behave any differently during your pre-bedtime routine than you would on any other night and try to get to bed and wake up around your usual timeswhich should constitute a full night’s sleep. Once you are wearing the device properly, turn it on when you get into bed even if you don’t fall asleep right away. The best rule is to try to get at least 3 straight hours of uninterrupted sleep for more accurate results. 

What If I Wake Up During the Night?

If you need to get up in the middle of the night for any reason (use the bathroom, let the dog out, check on a child, get some water, etc.), please make sure to leave your device on and recording. Again, it is imperative that you wear the activated device all night regardless of what happens during that time. Once you wake up and get out of bed for the day, only then should you turn off the device and take it off to send it back for analysis. 

Sleep Apnea Test Results

Who Reviews Sleep Apnea Test Results?

While an in-lab sleep test takes much longer to analyze because of all the extra data they must interpret, home sleep tests have a much faster turnaround time. Once you wear the device during a successful night of sleep, you will mail it back for the data to then be interpreted by a board-certified sleep physician. 

What Do The Results Mean?

Once those results are interpreted properly and a diagnosis has been given, a patient care representative will call you to discuss your results and treatment options, if applicable. This process can take between 10-14 business days. 

Your sleep test results will cover a variety of data. A few of these vitals will be sleep efficiency, the apnea hypopnea index (AHI), the oxygen saturation index (OSI), and heart rate. 

Sleep Efficiency

Sleep efficiency is a term for the number of minutes you spend asleep divided by the total sleep recording period. If you have high sleep efficiency, you are spending more time asleep than you are spending awake.

Apnea Hypopnea Index

Also called AHI, the Apnea Hypopnea Index is the average number of times you experience an apnea or hypopnea per hour of sleep. An apnea is a complete obstruction of your airway for more than 10 seconds whereas a hypopnea is only a partial obstruction of the airway. Most people suffer from an average of 0-5 events per hour. An AHI above 5 is considered abnormal and may lead to a sleep apnea diagnosis.

Oxygen Desaturation Index

This represents the number of times your oxygen levels drop during time spent asleep. This measurement is typically used to examine or diagnose sleep disordered breathing. For reference, oxygen levels are generally expected to stay above or around 90%.

Heart Rate

This is likely the clearest term of the set, but it is also a vital piece of sleep study data. Your heart rate is frequently measured through a small rubber apparatus that goes over your index finger. Most adults, depending on levels of health, have a resting heart rate of 60-100 beats per minute (BPM). If you come in over 100 BPM during rest or sleep, it is a condition known as tachycardia, while having a heart rate under 60 BPM is called bradycardia. If you fall into either of these designations, please consult your primary care physician.

All of these pieces of data come together to measure whether or not you suffer from OSA, and, if you do, at what level of severity. The three levels are mild (5-15 apnea events per hour), moderate (15-25 apnea events per hour), or severe (25+ apnea events per hour). You can learn more about your results, how the test collects your vitals, and who interprets your sleep test data in this resource on what sleep test measure.

 

What’s Next After I Receive My Results?

After receiving your official diagnosis you can speak with your provider’s patient care representatives to discuss which treatment option may be right for you. As soon as treatment begins, many patients feel more rested, alert, and happier because they are getting the restorative, uninterrupted sleep we all need. 

Treatment After Your Sleep Apnea Diagnosis

Therapies For Sleep Apnea

While many experience anxiety or stress around the decision to treat their sleep apnea with continuous positive airway pressure (CPAP) or automatic positive airway pressure (AutoPAP) machines, these devices remain the  for those suffering from all levels of sleep apnea. 

CPAP and AutoPAP Treatment

For those curious about the differences between these two machines, the CPAP provides a continuous stream of light air pressure that prevents obstructions to the throat and chest during sleep, preventing apnea events. 

The AutoPap is a newer, more innovative option that senses obstructions or disturbances in your breathing and provides an increasing amount of airway pressure until the obstruction is eliminated. This is an extremely effective treatment for those experiencing severe snoring, apneas, and hypopneas during sleep. Some newer AutoPAP machines include built-in humidifiers to combat dryness that can result from the increased airway pressure. 

Oral Appliances May Be An Option

For those who suffer from mild to moderate sleep apnea, oral appliances can be an effective treatment option. Resembling mouth guards, the appliances position the jaw to allow for unobstructed breathing by preventing the jaw from relaxing too far back in the throat. While the FDA has approved the use of these dental appliances when prescribed by a dentist, many of the over-the-counter appliance options are not FDA approved for sleep apnea. Be sure to do significant research if you’re interested in pursuing this treatment option.

Surgery For Sleep Apnea

There is still some skepticism surrounding the effectiveness of surgery to alleviate sleep apnea, but there have been some promising studies in recent years. Currently, the most common procedure to treat sleep apnea is uvulopalatopharyngoplasty, which surgically removes throat tissues that can obstruct the airways in deep sleep. But statistics show that this procedure only helps patients roughly 60% of the time. 

Though less invasive than uvulopalatopharyngoplasty, upper airway stimulation therapy is a newer treatment that implants a series of sensors beneath the skin of the throat and chest areas. During sleep, should the sensors detect obstructions, the implants send some mild stimulation to help clear the obstruction and reinstate normal breathing. 

Lifestyle / Home Remedies

There are a few lifestyle changes that are fairly well known to help reduce your risk of sleep apnea, or, in some cases, remove risks and symptoms for those with more mild apneas. 

Weight Loss

Your best bet to start reducing your risk for apnea related strokes or high blood pressure is weight loss. While sleep apnea affects people on every BMI level, those with higher BMIs are at increased risk. Losing weight through controlled diet and exercise can remove the existing pressure on your throat and reduce obstructions. 

Stop Smoking

The other change you’ll want to consider is to quit smoking. Smoking is not known to be a direct cause for sleep apnea, but decreased effectiveness of the lungs or lung capacity certainly does not help. Smoking is known to cause inflammation in the throat, lungs, and chest which can easily worsen apnea symptoms. 

Use a Humidifier 

Humidifiers are a common household accessory that adds moisture to the air to help you breathe easier. Dry air can easily irritate your respiratory system, so adding some moisture to the air will help you breathe more clearly while also encouraging your sinuses to drain, removing blockages and facilitating better breathing. 

Essential Oils Can Be Helpful

While a humidifier by itself may be enough to help open up your airways, many will also suggest adding one or two drops of essential oils into your humidifier’s reservoir. There are several oils with natural anti-inflammatory and/or soothing benefits, but you’ll want to try to find eucalyptus, peppermint, or lavender oils to help with sleep apnea symptoms. If you find this helps you sleep at night, be sure to carefully follow your humidifier’s care manual as dirty humidifiers can also add mold and bacteria into the air if not regularly cleaned. 

Yoga & Breathing Exercises

Much like any other holistic treatment, Yoga is helpful because it allows you to connect with your body in new ways. Because of the relaxation and tension relief that often happens during yoga practices, many yoga exercises can help reduce inflammation and help you open your airways--not to mention help you tap into your personal breathing patterns and rhythms. Yogic breathing techniques can help reduce your apnea. 

While there are many exercises you can find online, it is also helpful to consult a yoga instructor so they can help you find exercises for your individual breathing needs. Regular practice can help some of the symptoms of sleep apnea, like headaches and inflamed airways, but be wary about relying on this to solve your problem as sleep apnea is a serious medical condition that worsens if not treated. 

Try Out A New Sleep Position

Of this list, changing your sleep position may be the most simple solution to your apnea symptoms but can also be the most difficult to regulate. Because many of us move during sleep, sleep position can be one of the more challenging sleep behaviors to change. Sleep apnea is most common in those who tend to sleep on their backs. During sleep, all your muscles relax and tend to sag, especially those in your mouth, throat, and chest. When sleeping on your back, this extra sagging obstructs the airway, causing blockages that inhibit your ability to breathe at night. Occasionally, this only results in snoring, but can worsen and turn into sleep apnea. 

Sleep on Your Side or Stomach

To alleviate some of your sleep apnea symptoms, try sleeping on your side or your stomach. This will allow the muscles to sag in directions that will cause fewer obstructions to your airways. There are special pajamas or pillows you can find online to help keep you in these new sleeping positions throughout the night. 

If you’re wanting to try it before committing to a product, we suggest placing a pillow in between your legs and laying on your side. The pillow will make it more challenging to roll over and lay on your back. Though side effects of sleep apnea, like snoring, can be helped by simple changes like your sleep position, they don’t erase the underlying causes of sleep apnea. 

Many of those who are suffering from sleep apnea don’t even know they have it. But, you don’t have to go undiagnosed and untreated. 

Home sleep test are a great option for those who believe they suffer from this disorder because they allow you to get quick, effective answers from the comfort of home without the steep in-lab sleep study price tag. 

If you have any questions about Good Sleep's at-home sleep test or exploring your treatment options, you can speak with a member of our Good Sleep Customer Care Team by calling 940-465-3822. 

Don’t waste any more time and start getting the quality, restful sleep you deserve today. 

 

1https://www.ncbi.nlm.nih.gov/pubmed/18250205

2https://www.ncbi.nlm.nih.gov/pubmed/25186268

3https://aasm.org/rising-prevalence-of-sleep-apnea-in-u-s-threatens-public-health/

4https://sleepfoundation.org/sleep-disorders-problems-list/can-kids-get-sleep-apnea

5https://www.sleepapnea.org/treat/childrens-sleep-apnea/

6http://www.nejm.org/doi/full/10.1056/nejm199304293281704

7 https://www.ncbi.nlm.nih.gov/pubmed/25682233

8http://thorax.bmj.com/content/early/2018/02/24/thoraxjnl-2017-210943

9http://www.worldcat.org/title/wake-up-america-a-national-sleep-alert-report-of-the-national-commission-on-sleep-disorders-research/oclc/34483350

10 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3449487/

11http://jnnp.bmj.com/content/89/4/418

12https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990435/