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Caring for many patients over the years with un-diagnosed OSA, it has been a common excuse for not pursuing treatment because of the required in-facility sleep study needed to obtain a diagnosis.  The HST removes many barriers for a significant patient population. OSA is most frequently treated with Continuous Positive Airway Pressure, more commonly referred to as CPAP.  A diagnosis of OSA and prescription are needed to obtain this medical device which is worn by the patient while sleeping to keep the airway unobstructed.  HST is an advancement in healthcare possible because of the advancements made in informatics.  Accessibility to testing, convenience and almost immediate analysis of the recorded data improves patient acceptance and compliance with the innovation.

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Not all patients are suitable candidates for this type of testing, it is not approved for use in children

Some insurers (Medicaid, Medicare) do not reimburse for HST

Inability to distinguish between OSA and other sleep disorders such as hypersomnia, narcolepsy, and circadian rhythm sleep disorders

Testing equipment placed by patient and is not monitored by a technician, inaccurate placement or malfunction may lead to inaccurate results or additional testing

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Provides a more natural sleeping environment which for some patients allows more accurate results

Reduced costs for some patients with the reduction of visits necessary to obtain a diagnosis which is necessary to prescribe appropriate treatment

Recognized by the American Academy of Sleep Medicine as an acceptable diagnostic test for suitable patients, for the diagnosis of OSA (Woodson & Ishman, 2013)

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Southern California Pulmonary and Sleep Disorders Medical Center

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Balakaren Dr Jim Sears forsoker NovaSom Hemservice somn diagnossystemet for att ta reda pa om han har somnapne.

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Obstructive sleep apnea (OSA) is a frequently under-diagnosed condition that is linked to significant morbidity and mortality.  Common symptoms include snoring, restless sleep, daytime fatigue, and morning headaches.  Obstructive sleep apnea is the most common sleep-related breathing disorder, despite high prevalence, 70-80% of patients with OSA remain undiagnosed (Cattrysse, Peeters, Calaerts, Ferson, & Degryse, 2014).  If not treated, OSA is connected to an increased risk of cardiac, respiratory, and metabolic conditions, including hypertension, stroke, congestive heart failure, and sudden death (Smith, 2015).

In-facility polysomnography (PSG) is the historical standard for the diagnosis of OSA. For the appropriate patient, however, home sleep tests (HSTs) can be used to diagnose this condition. PSG and HSTs use the same respiratory equipment, pulse oximetry equipment, and movement and position sensors (Smith, 2015). Data generated from each test is analyzed in the same manner. A number of studies of several different models of HST have concluded that the results are comparable to the traditional in-facility PSG (Smith, 2015).

HST allow a patient to sleep in their own home, following their normal sleep routines.  They wear the monitoring device for the prescribed number of hours of sleep and the device will alert the patient to any malfunctions or monitor displacement.  Having the HST completed at a much more convenient time, place and familiar surroundings for the patient eliminates the barrier of finding a night to sleep at an in-facility testing center and being in unfamiliar sleep surroundings.

Several models of HST transmit the collected data over the internet, saving the patient a trip to deliver the device to the provider’s office for data analysis.  This data can then be immediately uploaded into the patient’s EHR, evaluated and treatment prescribed based on findings.

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Image of patient with HST in place. Image courtesy of Kristen Pickard, Embletta.

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Image of patient with HST in place. Image courtesy of Kristen Pickard, Embletta.

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Cattrysse, F., Peeters, M., Calaerts, S., Ferson, K., & Degryse, J. (2014). Detection of sleep apnea by case finding and home monitoring with Somnolter: a pilot study.  BioMed Central Research Notes. (7)(616) 1-9 retrieved from http://biomedcentral.com/1756-0500/7/616

Smith, W. (2015). Obstructive sleep apnea and home sleep monitoring overview of obstructive sleep apnea. Medscape. Retrieved from http://emedicine.medscape.com/article/1518830-overview#a1

Woodson, B. & Ishman, S. (2013). Portable monitoring for diagnosis of sleep apnea. Current Otorhinolaryngology Report. (1) 16-19.

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At Home Monitoring for the Diagnosis of Obstructive Sleep Apnea 

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At Home Monitoring for the Diagnosis of Obstructive Sleep Apnea 