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Home Sleep Tests

We use various home sleep test systems to increase patient access to this critically important information about their health. For both pediatric and adult patients who exhibit signs and symptoms of sleep-related breathing disorders, we recommend use of this minimally-invasive equipment in the comfort of your own home and bed to gather data to identify patterns in the breathing, heart rate, blood oxygen saturation, and snoring. In some cases, we are screening for evidence of more severe sleep conditions such as obstructive sleep apnea so that we can refer the patient to a sleep physician; but in many cases, we are identifying these patterns associated with suboptimal oral health conditions and can begin treatment via a combination of lifestyle changes, over-the-counter and holistic remedies, and intra-oral appliance therapy. 

Home Sleeping Test

Do you, your child, or your partner suffer from any of these signs & symptoms commonly associated with sleep-related breathing disorders?

Snoring Child
Snoring at night
  • Snoring

  • Labored or difficulty breathing

  • Mouth breathing

  • Nasal congestion

  • Anxiety, depression

  • Issues with excess weight

  • Hyperactivity or symptoms of ADD/ADHD

  • Poor ability or difficulty in work or school

  • Difficulty listening &/or interrupts often

  • Teeth grinding

  • Morning headaches

  • Night sweats

  • Sleep talking or walking

  • Restlessness or "active" sleep

  • Fatigue or irritability during the day

  • Frequent night urination or prolonged bedwetting

  • Frequent throat, sinus, ear, or upper respiratory infections

  • Chronic sugar cravings

  • Sucking habit

  • Issues with speech

Then testing sleep & nighttime breathing is an important next step to restore optimal health!

Sleep and breathing disorders can have a profound impact on overall health, yet many of these conditions go undiagnosed due to barriers such as inconvenience and cost associated with traditional polysomnography. Recently, home sleep tests (HSTs) have gained popularity due to their accessibility and cost-effectiveness.

HSTs are portable devices designed to monitor physiological data during sleep in the comfort of the patient's home. They measure specific parameters related to sleep and breathing, snoring, blood oxygenation saturation, and heart rate.

HSTs are portable devices designed to monitor physiological data during sleep in the comfort of the patient's home1. They measure specific parameters related to sleep and breathing, snoring, blood oxygenation saturation, and heart rate. This data allows us to evaluate for sleep-related breathing disorders and to screen for evidence of obstructive sleep apnea (OSA), a sleep disorder characterized by repeated episodes of partial or complete upper airway obstruction during sleep 2.

What is Measured on a Home Sleep Test?
  1. Apnea-Hypopnea Index (AHI): The AHI quantifies the severity of sleep apnea. It measures the average number of apneas (pauses in breathing) and hypopneas (reductions in airflow) per hour of sleep3. This index is used to identify the severity of compromised sleep and breathing at night, and is a primary factor in deciding whether a patient must be referred to a sleep physician for a comprehensive evaluation and polysomnogram. 

  2. Respiratory Disturbance Index (RDI): The RDI includes not only apneas and hypopneas but also other respiratory events that disrupt sleep. Like the AHI, the RDI is calculated per hour of sleep4

  3. Oxygen Saturation Levels: This measure reflects the percentage of hemoglobin in the blood that is saturated with oxygen. Healthy oxygen saturation levels during sleep are typically 95-100%. Levels at or below 94% are generally considered abnormal and can indicate a sleep disorder5.

  4. Snore Index: The snore index represents the average number of snores per hour. While there isn't a universally accepted "normal" range, an elevated snore index might suggest increased upper airway resistance and potential sleep disordered breathing 6.

Benefits of Home Sleep Tests

HSTs offer several advantages over in-lab sleep studies. They're convenient, allowing patients to maintain their regular sleep routine in the comfort of their own home. HSTs are also more cost-effective, making them an attractive option for many patients and healthcare systems7.

In addition to these benefits, HSTs have demonstrated their clinical utility. Several studies have shown that HSTs can accurately screen for OSA in certain populations, making them an effective tool in the right circumstances8. However, HSTs are not suitable for all patients, and we are not using them to formally diagnose any sleep disorders. Therefore, they should be used judiciously and complemented by a thorough clinical evaluation.

Pulse Oximeter
Alternatives to Home Sleep Tests

Most of our adult patients can tolerate our comprehensive home sleep tests quite well and allow us to get very reliable data over a 3-night study. Not all of pediatric patients respond well to the equipment, so as an alternative, we also offer a pulse oximeter only test, which details blood oxygen saturation and heart over the course of the evening. This can still be very helpful in understanding what is going on with a patient over night, but it just provides less data than the comprehensive test.

Another alternative includes the more invasive, in-clinic or in-hospital polysomnogram. While this testing is intended to provide the most accurate data related to a patient's sleep, there are significant downsides including the following:

  • It requires a referral to a sleep physician or pulmonologist for a preliminary work up and referral for PSG

  • It is performed in a clinic or a hospital, which can be uncomfortable for a patient, especially a child to be out of their bed and their normal sleep routine

  • It is more expensive 

While this is not our first option due to the aforementioned reasons, we do recommend this diagnostic process for our more severe cases with higher risks of complications. 

Lastly, in some cases, a patient cannot tolerate or does not wish to proceed with any type of baseline sleep study. This limits our ability to monitor accurately any progression in their condition (if a patient elects to proceed with treatment), but we are able to use qualitative signs and symptoms as an additional resource to screen for the severity of these conditions and then to observe improvement over time. 

If you, your child, or your partner suffer from poor quality sleep, we recommend you schedule a preliminary visit with us ASAP. Pending what we discover in a comprehensive clinical exam, review of history, and home sleep study, we can create a a plan moving forward to help you achieve and maintain peak health for a lifetime. 

References
  1. Berry, R. B., Budhiraja, R., Gottlieb, D. J., Gozal, D., Iber, C., Kapur, V. K., ... & Tangredi, M. M. (2012). Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Journal of Clinical Sleep Medicine, 8(05), 597-619. 

  2. Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M. (2013). Increased prevalence of sleep-disordered breathing in adults. American Journal of Epidemiology, 177(9), 1006-1014. 

  3. Berry, R. B., Brooks, R., Gamaldo, C. E., Harding, S. M., Lloyd, R. M., Marcus, C. L., & Vaughn, B. V. (2015). The AASM manual for the scoring of sleep and associated events. American Academy of Sleep Medicine. 

  4. Guilleminault, C., & Brooks, S. N. (2001). Excessive daytime sleepiness: a challenge for the practising neurologist. Brain, 124(8), 1482-1491. 

  5. Stöwhas, A. C., Latshang, T. D., Lo Cascio, C. M., Lautwein, S., Stadelmann, K., Tesler, N., ... & Bloch, K. E. (2013). Effects of acute exposure to moderate altitude on vascular function, metabolism and systemic inflammation. PloS One, 8(8), e70081. 

  6. Nakano, H., Hayashi, M., Ohshima, E., Nishikata, N., & Shinohara, T. (2004). Validation of a new system of tracheal sound analysis for the diagnosis of sleep apnea-hypopnea syndrome. Sleep, 27(5), 951-957. 

  7. Rosen, I. M., Kirsch, D. B., Chervin, R. D., Carden, K. A., Ramar, K., Aurora, R. N., ... & American Academy of Sleep Medicine Board of Directors. (2020). Clinical use of a home sleep apnea test: an American Academy of Sleep Medicine position statement. Journal of Clinical Sleep Medicine, 16(10), 1669-1675. 

  8. Masa, J. F., Corral, J., Pereira, R., Duran-Cantolla, J., Cabello, M., Hernández-Blasco, L., ... & Barbe, F. (2011). Effectiveness of home respiratory polygraphy for the diagnosis of sleep apnoea and hypopnoea syndrome. Thorax, 66(7), 567-573. 

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