Last updated: Apr 08, 2008
steve-posin
Steve's home test diagnosed him with sleep apnea.
(STEVE POSIN)
For patients who are suspected to have obstructive sleep apnea, it's important to be tested and begin treatment as soon as possible. So in 2001 when Steve Posin's doctors released him from the hospital after surgery for a clogged artery, they told him to see his primary care physician right away. They'd noticed over the course of his stay that he often stopped breathing in his sleep, a condition that was likely wearing down his heart and contributing to his cardiovascular problems.


Sleep labs weren't as widespread then, as they are today, so Posin's doctor prescribed him a home test that could confirm the diagnosis. He gave Posin, now 63, information for diagnostics company SleepQuest, about 30 miles from his home in San Francisco.

A SleepQuest representative delivered the home test to Posin's office and showed him how to use it. "There were electrodes that hooked to my forehead and my wrist and finger, and a tube that went under my nose," he recalls. "It felt a little silly, but not obtrusive or uncomfortable."

He'd never been a sound sleeper and typically woke several times through the night; the device didn't keep him up any more than usual. The machine recorded data as he slept, and the next day the company came and picked it up.

Posin's report showed that he had severe sleep apnea, so he drove to the SleepQuest offices to pick out a continuous positive airway pressure (CPAP) machine to keep his airways from closing up. Technicians helped him find a face mask that fit comfortably and calibrated the air pressure based on the results of his test.

Home tests aren't always the best bet
Because Posin's case was almost certainly sleep apnea, he was a good candidate for a home test, says Lawrence Epstein, MD, medical director of Sleep HealthCenters in Brighton, Mass., and instructor of medicine at Harvard Medical School.

Had Posin's test results come back negative, though, he should have still had an overnight study in a sleep lab. Home tests have higher margins of error, since equipment may be worn incorrectly or slip off during the night, which means you might have sleep apnea even if a test says you don't.

Consider your insurance
Posin's insurance covered his test, which is something else to consider when choosing between home and lab tests for sleep apnea. Although research suggests that the likelihood of a correct diagnosis is high when prescribed properly, about half of all major insurance plans still consider home tests too experimental and don't cover them. Home tests run from about $150 to $650.

This year Medicaid and Medicare began covering home sleep tests for qualifying patients, and many private companies are following their lead. For those who don't have insurance and those who must pay a high deductible for in-lab sleep tests, which can run several thousand dollars, home tests could be a cheaper option.