Are home sleep apnea tests accurate?

Research cites concerns about the accuracy of home tests because of the risk of misdiagnosis. One report found an overall sleep apnea misdiagnosis rate of 39% after using an at-home test. [8]Massie F, Van Pee B, Bergmann J. Correlations Between Home Sleep Apnea Tests and Polysomnography Outcomes Do Not Fully Reflect the Diagnostic Accuracy of These Tests. Journal of Clinical Sleep Medicine. March 1, 2022. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883090/?report=reader

What to Know About At-Home Sleep Apnea Tests

Apr 16, 2024

Fact Checked

At-home sleep apnea tests are cost-effective and convenient, but your results should be analyzed by an expert.

Written by: Lauren Evoy Davis

Medical Reviewer: Chester Wu, MD

Reviewed by: Susan Stiles, PhD, Senior Director of Healthy Aging Innovations at NCOA

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Only $189

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Sleep test done in comfort of your home

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Purchase a CPAP machine after receiving test results

At Home Sleep Apnea Tests: Key Takeaways

At-home sleep apnea tests can help diagnose sleep apnea from the comfort of your bed.
You should get a prescription from your doctor for an FDA-approved home sleep apnea test.
An at-home test may not be as accurate as a monitored test in a sleep laboratory.

If you suddenly gasp for air in the middle of the night or experience frequent daytime sleepiness, you should ask your health care provider about sleep apnea. Obstructive sleep apnea (OSA) causes the upper airway—nasal cavities, oral cavity, throat, and voice box—to narrow and restrict your breathing for at least 10 seconds, causing reduced airflow and lower blood oxygen levels.

OSA affects millions of people in the United States and upwards of 1 billion globally, many of whom go undiagnosed. ^[1] Left untreated, OSA can lead to serious physical and mental health conditions, like cardiovascular issues, high blood pressure, stroke, and depression. ^[2] The American Academy of Sleep Medicine (AASM) recommends using a CPAP machine at night to treat your OSA and get a better night’s sleep. ^[3]

Sleep apnea requires an official diagnosis, but you can take a test in a medical setting or at home. Read our guide on what to expect from an at-home test, how to prepare, who they’re right for, and other considerations.

What is an at-home sleep apnea test?

An at-home sleep apnea test is a non-invasive breathing monitor you wear overnight. It detects snoring and measures your heart rate, breathing, and oxygen saturation. Some newer models also measure the quality of your sleep or your sleep cycles. You should get a prescription for an FDA-approved sleep apnea test from your heath care provider. The tests available for purchase without a prescription are not recommended.

At-home sleep apnea tests typically come with:

A pulse oximeter to measure blood oxygen saturation levels and heart rate
A recording device you wear like a wristwatch

A finger sensor to detect changes in breathing patterns while you sleep
A recording device you wear like a wristwatch

An at-home test may be more comfortable than a lab test, which requires you to stay in a medical facility and be monitored by sleep technicians overnight. After your at-home test, a clinician or sleep specialist should assess the results to check for OSA or other sleep disorders. ^[4]

At-home sleep apnea tests to try

Many sleep brands and companies offer at-home sleep apnea tests, so it’s important to do your research to find one that meets your preferences and needs. The Sleep Doctor At-Home Sleep Apnea Test may be a good fit. This FDA-cleared disposable sleep apnea test has finger, wrist, and chest sensors that monitor seven metrics associated with sleep apnea. When worn properly, it can determine if you qualify for a diagnosis. Results are sent to your email with a personalized sleep report and therapy recommendations to discuss with your health care provider. See our Sleep Doctor review to learn more.

What does an at-home sleep apnea test measure?

A sleep apnea test “assesses the severity of obstructive sleep apnea by calculating the average instances of breathing pauses per hour while in bed,” said Jennifer Silver, MD, a licensed sleep expert at Macleod Trail Dental in Alberta, Canada.

Depending on your needs and preferences, several types of tests are available to assess sleep apnea. The tests are designed to measure specific health metrics instead of overall sleep quality, such as your breathing effort, snoring, and heart rate. Your health care provider will provide you with a prescription for the best option for you.

Type 1

Type 1 is the “gold standard” of sleep apnea tests, called polysomnography (PSG). It is conducted overnight in a sleep laboratory by a credentialed sleep technician who can troubleshoot issues with the equipment and respond to your needs. You wear a device on your nose that looks like a nasal cannula, a chest belt that measures your heart rate, and a pulse oximeter to measure your blood oxygen saturation. You will also be attached to monitors that track brain waves and body movement.

The sleep technician observes and records the following:

Sleep stages
Breathing effort
Airflow
Snoring
Carbon dioxide output
Oxygen saturation
Heart rate and rhythm
Body position
Limb movements

Type 2

A type 2 test uses the same devices to measure the same information about your sleep patterns as a type 1 test, but it can be conducted at home or in a sleep lab. Unlike a type 1 test, there is no sleep technician on hand to monitor your test.

Type 3

Type 3 is the most commonly used at-home test for sleep apnea. ^[5] You’ll be provided with a device to record certain heart and lung functions and given instructions to set up the test. These tests typically track the following: ^[6]

Breathing effort
Airflow
Snoring
Oxygen saturation

Type 4

Type 4 tests measure up to three health metrics, such as airflow, blood oxygen levels, and heart rate, but are the most limited type of test. These are typically used to screen for sleep apnea and may require a more comprehensive test for full diagnosis.

STOP-BANG questionnaire

Another way to assess sleep apnea severity is the STOP-BANG score, developed by Frances Chung, MBBS, a professor of anesthesia at the University of Toronto, Canada. STOP-BANG is an acronym based on the signs and symptoms of OSA. Chung developed the questionnaire as a screening tool for health care providers to gauge the likelihood and severity of OSA. ^[7]

Each symptom or biological factor counts as one point. You are considered at low risk if you have two or fewer points. If you tally three or more points, you are at moderate to high risk for OSA and should talk to your doctor.

S	Snoring
T	Tiredness during the day
O	Observed apnea (gasping for breath)
P	High blood pressure
B	Body mass index higher than 35
A	Age 50 and older
N	Neck circumference wider than 16 inches
G	Gender (men are at higher risk of OSA)

How to prepare for an at-home sleep apnea test

Preparing for your at-home sleep apnea test is important to ensure you get the most accurate results possible. On the day of your test, it’s helpful to: ^[8]

Avoid or limit caffeine
Avoid alcohol
Take all prescription medications
Avoid naps
Eat your usual meals, but do not eat dinner too close to bedtime
Go to sleep and wake up at your normal times

Before putting on the testing equipment, set up your bedroom as usual and put on comfortable pajamas. Read the testing instructions carefully to apply the chest belt, nasal cannula, and pulse oximeter correctly.

Pros of an at-home sleep apnea test

Conducting an at-home sleep apnea test may be more convenient and comfortable than in a sleep lab, but you’ll still need to meet with a clinician.

“At-home sleep apnea tests can effectively diagnose OSA in certain individuals, provided that a qualified sleep specialist interprets the results,” Silver said.

Cost-effective

An at-home sleep apnea test costs between $100 to $500 compared to a laboratory test, which can cost thousands of dollars.

Convenient and private

You may be more comfortable taking a test in the privacy of your bedroom as opposed to a lab.

Less equipment

You don’t have to attach as many sensors to your head and body during an at-home test as you do with a laboratory test. For example, a type 1 sleep study in a lab also measures brain waves, muscle tone, and leg movements with attached monitors.

Cons of an at-home sleep apnea test

The downside to at-home tests is that they may not be as effective as monitored lab tests. Talk with your health care provider if you have any concerns about your at-home sleep study.

Less accurate

A 2022 report examining the validity of at-home sleep studies found an overall misdiagnosis rate of 39%. ^[9] Because the test is not supervised and only tracks certain health metrics, you also risk missing other sleep issues that a sleep technician may find during a monitored test.

Less patient satisfaction

A 2018 study found that although at-home tests are convenient, people report greater satisfaction with the on-site laboratory experience and professional analysis by a health care professional. ^[10]

May not rule out sleep apnea

Home tests can be inaccurate because you’re administering them yourself. If your results don’t indicate that you have sleep apnea but symptoms persist, your health care provider will likely recommend an in-lab study for confirmation.

Is an at-home sleep apnea test right for you?

If cost or comfort are your main priorities, you may prefer at-home tests over lab studies. They can be done for a lower price and without the hassle of scheduling and traveling to a sleep lab site.

“At-home sleep apnea testing is a convenient way for someone to test if they are experiencing sleep apnea or not,” said Lauren Thayer, DNP, a patient services manager at Yale New Haven Hospital in New Haven, Connecticut. “These at-home tests are a cost-effective alternative to a test done in an office,” she added.

But if you are at risk for other sleep issues, like restless leg syndrome or narcolepsy, it’s better to undergo more thorough testing at a sleep lab. At-home OSA tests will not rule out other conditions that mimic OSA, such as gastroesophageal reflux disease (GERD), asthma, swallowing disorders, seizures, and panic attacks. ^[11] If you are concerned about the accuracy of an at-home test, you should also seek on-site testing at a sleep lab.

Additional ways to improve sleep

In addition to seeking a diagnosis for sleep apnea, there are other ways to improve sleep. A supportive mattress can significantly improve sleep quality by balancing support and comfort. While there’s no single mattress solution for everyone, it’s possible to find the best mattress for your needs by factoring in your body type, preferred sleep position, and any personal considerations, such as back pain.

Keep in mind those with sleep apnea are advised to sleep on their sides, and the best mattresses for side sleepers offer sufficient contouring and support. If you prefer the customized support and additional features provided by the best adjustable beds, they also work well for those who use a CPAP machine for sleep apnea.

Bottom line

OSA can be treated using a CPAP machine, which requires a prescription and an official sleep apnea diagnosis. At-home sleep apnea tests provide a convenient and low-cost alternative to lab-based sleep studies in some cases. Still, there is a potential for less accurate results or misdiagnosis compared to a test conducted at a sleep lab. Talk with your health care provider to see if a home sleep apnea test is right for you.

Frequently asked questions

Research cites concerns about the accuracy of home tests because of the risk of misdiagnosis. One report found an overall sleep apnea misdiagnosis rate of 39% after using an at-home test. ^[8]

Many companies require a prescription for a home test, but some online retailers do not require a prescription. Some health insurance providers cover the cost of at-home tests but may require a prescription.

These two terms mean the same thing. Health care practitioners use the terms interchangeably.

Yes, the equipment is portable, and you can use the bathroom during an at-home test.

Have questions about this review? Email us at reviewsteam@ncoa.org.

Sources

Malhotra A, et al. Metrics of Sleep Apnea Severity: Beyond the Apnea-Hypopnea Index. Sleep. July 9, 2021. Found on the internet at https://academic.oup.com/sleep/article/44/7/zsab030/6164937
Senaratna CV, et al. Prevalence of Obstructive Sleep Apnea in the General Population: A Systematic Review. Sleep Medicine Reviews. August 2017. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/27568340/
Patil SP, et al. Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep Medicine. Feb 15, 2019. Found on the internet at https://jcsm.aasm.org/doi/10.5664/jcsm.7640
Do TQ, et al. Precision Medicine in Adult Obstructive Sleep Apnea and Home Diagnostic Testing: Caution in Interpretation of Home Studies Without Clinician Input Is Necessary. Frontiers in Neurology. Feb. 21, 2022. Found on the internet at https://www.frontiersin.org/articles/10.3389/fneur.2022.825708/full
ATS/ACCP/AASM Taskforce Steering Committee. Executive Summary on the Systematic Review and Practice Parameters for Portable Monitoring in the Investigation of Suspected Sleep Apnea in Adults. American Journal of Respiratory and Critical Care Medicine. May 15, 2004. Found on the internet at https://www.atsjournals.org/doi/10.1164/rccm.169.1160
Canadian Sleep Consultants. Level 1, Level 3 and Level 4 Sleep Testing. Found on the internet at https://www.sleepconsultants.ca/level-1-level-3-level-4-sleep-testing
Pivetta B, et al. Use and Performance of the STOP-Bang Questionnaire for Obstructive Sleep Apnea Screening Across Geographic Regions: A Systematic Review and Meta-Analysis. JAMA Network Open. March 2, 2021. Found on the internet at https://www.frontiersin.org/articles/10.3389/fneur.2022.825708/full
Lawrence General Hospital. Preparing for a Home Sleep Study. Found on the internet at https://www.lawrencegeneral.org/services-and-centers/sleep-center/preparing-for-at-home-sleep-study
Massie F, et al. Correlations Between Home Sleep Apnea Tests and Polysomnography Outcomes Do Not Fully Reflect the Diagnostic Accuracy of These Tests. Journal of Clinical Sleep Medicine. March 1, 2022. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883090/
Kapur VK, et al. Patient Satisfaction With Sleep Study Experience: Findings From the Sleep Apnea Patient-Centered Outcomes Network. Sleep. Aug. 1, 2018. Found on the internet at https://academic.oup.com/sleep/article/41/8/zsy093/4993779
Kline LR. Clinical Presentation and Diagnosis of Obstructive Sleep Apnea in Adults. Up To Date. 2023. Found on the internet at https://www.uptodate.com/contents/clinical-presentation-and-diagnosis-of-obstructive-sleep-apnea-in-adults

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