The Best At-Home Sleep Apnea Test
Itamar WatchPAT-One Home Sleep Apnea Test
Uses WatchPAT, an FDA and DOT approved portable sleep apnea diagnostic device
- OSA
Results are instantly shared with the ordering provider
You will receive a detailed Sleep Report, along with follow-up recommendations
Anyone who snores, feels tired, or suspects they may have OSA
Testing.com may refer users to content and/or products on other sites owned and operated by OneCare Media, LLC, such as SleepApnea.org and SleepFoundation.org.
About At-Home Sleep Apnea Tests
Purpose of at-home sleep apnea tests
The purpose of at-home sleep apnea tests is to diagnose or monitor obstructive sleep apnea. Obstructive sleep apnea (OSA) is a disorder that causes repeated disruptions in breathing during sleep.
Sleep apnea frequently leads to daytime drowsiness and has been linked to other health problems including cardiovascular disease. In OSA, these disruptions occur because the airway in the upper throat becomes blocked.
A diagnosis of obstructive sleep apnea requires testing that shows a certain number of breathing disturbances during sleep. An in-clinic sleep study, known as a polysomnogram, is the most common way that sleep apnea is diagnosed, but home sleep apnea tests can be used for certain patients.
At-home testing can also be used to monitor how a patient’s sleep apnea changes over time.
For people who are being treated for OSA, testing can provide data about whether breathing during sleep has improved.
Whether in-clinic or at-home, sleep apnea testing is generally only prescribed if you have symptoms that are consistent with obstructive sleep apnea.
A hallmark symptom of sleep apnea is excessive daytime sleepiness that occurs on most days. Other common OSA symptoms include regular and loud snoring as well as gasping or choking during sleep. Because they occur while a person is asleep, these symptoms may first be detected by a bed partner or family member.
Sleep apnea tests may also be prescribed if you have risk factors or health conditions that may be caused by OSA. To identify these factors, your doctor may conduct a physical examination and a review of your overall health. Potential risk factors include:
- Enlarged tongue or tonsils or other anatomical features that contribute to narrowing of the airway
- Obesity
- Older age
- Cigarette smoking
- Family history of obstructive sleep apnea
- Use of certain drugs
After reviewing signs, symptoms, and risk factors, your doctor can help determine if sleep apnea testing is appropriate in your situation. At that point, they can address whether in-clinic or at-home testing better fits your situation.
In addition to diagnosing sleep apnea, certain home testing devices may be used to measure your response to treatment for obstructive sleep apnea.
What does the test measure?
Home sleep apnea tests include multiple sensors to monitor various aspects of your sleep. Because sleep apnea is a disorder of breathing, these tests are designed to assess respiration and oxygen levels.
There are different types of devices for home sleep apnea testing, and the exact measurements that are taken can vary based on the kinds of sensors included in a specific device or test kit.
Experts in sleep medicine recommend that at-home sleep apnea testing include at least the following three measurements, recorded for a minimum of four hours:
- Nasal pressure
- Movement of the chest and abdomen, which reflects breathing
- Oximetry, which is the level of oxygen in the blood
Another collection of three measurements that are considered to meet a minimum standard for at-home sleep apnea testing includes:
- Peripheral arterial tone (PAT), which is a finger-based sensor that tracks pulsations in the blood
- Oximetry
- Actigraphy, which tracks movement of the body
When these minimum requirements are met, the at-home test can produce a summary measurement to help detect sleep apnea. Examples of summary measurements that can be provided by at-home devices include:
- Apnea hypopnea index (AHI): The AHI is the number of two types of breathing disturbances detected per hour of sleep. Determining AHI requires knowing when you are actually sleeping, measured by a sensor for brain waves known as electroencephalography (EEG) that is not included in many at-home tests.
- Respiratory disturbance index (RDI) or respiratory event index (REI): The RDI or REI is the number of breathing disruptions per hour of device recording. RDI is used instead of AHI with devices that cannot distinguish whether you are sleeping during the test.
- pAHI or pRDI: These summary measures are the same as AHI or RDI, but the “p” denotes that respiratory disruptions were calculated by a PAT device worn on the finger rather than by direct measurement of nasal pressure and muscle movement.
Unvalidated at-home sleep apnea tests
It is important to know that not all products marketed as sleep apnea tests are proven to accurately detect obstructive sleep apnea.
As described in the previous section, experts at the American Academy of Sleep Medicine have identified a minimum number of sensors and types of measurements that should be included in any at-home sleep apnea test. Products that involve two or fewer sensors or that lack the proper measurements, such as some digital devices and many smartphone apps, are not able to diagnose sleep apnea.
Talk with your doctor before testing in order to make sure that you only use a validated test for sleep apnea.
How do at-home sleep apnea tests work?
At-home sleep apnea tests can either be ordered by your primary care physician, or you can have a telehealth visit or fill out an intake survey with a testing provider to determine if you are a good candidate to be tested.
Once it’s determined that you should get tested, you can order your at-home kit, which will be shipped to your door. The kit should provide all of the necessary instructions, you may be given a link to a video tutorial, or you may be asked to contact the provider by phone or video conference to walk you through how it works.
From there, you’ll likely be asked to sleep with the device for one or more nights and then return it either by mail or take it into your doctor’s office.
For at-home sleep apnea tests that monitor and record your sleep data via an app, your test information will be sent instantaneously to the provider digitally. Once someone reads the results, you’ll usually hear back with a full report and/or schedule a follow up consultation regarding treatment recommendations.
Some sleep apnea tests require you to mail back or take back the equipment, which has all of the sleep data stored. For those, it may take an additional day or two to get results depending on when the device reaches the testing company.
It is important to follow the instructions for use carefully. This includes making sure to apply and wear the sensors properly and to use them for the entire period of time that is recommended.
“The set up is easy to do and I think most adults can handle it independently,” says Fink.
Which at-home sleep apnea test should you choose?
Experts recommend certain minimum sensors be included in any testing device. For example, devices with two or fewer measurements generally are not accurate enough to reliably diagnose obstructive sleep apnea.
Benefits and Downsides of At-Home Sleep Apnea Tests
Both in-clinic sleep studies and at-home sleep apnea testing can be used to diagnose and assess obstructive sleep apnea. When compared with traditional sleep studies, at-home testing has a number of potential benefits and downsides.
Some of the main possible benefits of at-home sleep apnea tests include:
- Convenience: In-clinic sleep studies can be very inconvenient. Scheduling the test and actually spending the night in the sleep clinic can be logistically challenging, especially for people who don’t live near a clinic. An at-home test can make the testing process simpler and more convenient.
- Comfort: Most people are far more comfortable taking a test at home in their own bed instead of having to go to an unfamiliar sleep setting for overnight testing.
- Lower cost: The overall cost of at-home testing is generally much lower than in-clinic sleep studies, although the exact amount you pay can depend on whether you have health insurance that covers sleep apnea testing.
- Can collect data over multiple nights: At-home studies can be done for just one night or over several sleep periods. In contrast, in-clinic studies are usually just one night. This can be important because it is possible for the severity of sleep apnea to vary from night-to-night.
The key possible downsides of at-home sleep apnea testing include:
- May underestimate or fail to detect OSA: At-home testing is not as precise as an in-clinic sleep study and has a tendency to understate the extent of sleep apnea. In some cases, this can mean failing to diagnose mild cases.
- Provides less information: At-home tests have fewer sensors and recording devices, which means that there’s less information about the nature of your sleep. This affects the test’s precision and prevents at-home tests from detecting other types of sleep disorders.
- Not an option for all patients: At-home sleep apnea testing is not recommended for children, people with some coexisting health problems, people who have high-risk jobs, or anyone suspected to only have mild sleep apnea.
- May require follow-up testing: If your doctor strongly believes that you have sleep apnea but your at-home test is negative, it is common for a follow-up test in a sleep clinic to be recommended.
- Risk of device failure: Depending on the quality and design of the at-home device, there is a risk of it not functioning properly, which prevents collection of data about your breathing during sleep.
- No test oversight: In a sleep clinic, you are observed by a technologist throughout the test, allowing for quick remedies if a sensor falls off your body or if any other problems arise. With an at-home test, there is a risk of user error in setting up the test, and there’s no technologist to address potential problems.
The Best At-Home Sleep Apnea Test
There are a wide variety of brands and models of home sleep apnea tests. In many cases, your doctor or a sleep specialist will recommend a specific device, and a technologist will help set it up or provide instructions on how to use it.
The following section describes our top pick for at-home sleep apnea testing:
Methodology
At-Home sleep apnea tests were reviewed based on value, convenience, and availability of tests. These overall factors are based on data including price, insurance acceptance, comprehensiveness of tests, and how quickly you can get results and speak to a doctor. Sleep apnea test selections have been screened by Testing.com’s Medical Review Board.
Itamar WatchPAT-One Home Sleep Apnea Test
Uses WatchPAT, an FDA and DOT approved portable sleep apnea diagnostic device
PAT signal, heart rate, oximetry, actigraphy, body position, snoring, and chest motion
Results are instantly shared with the ordering provider
- OSA
Validated against standard polysomnography (PSG); users report
You will receive a detailed Sleep Report, along with follow-up recommendations
You will receive a detailed Sleep Report, along with follow-up recommendations
If you are diagnosed with OSA, a doctor will provide you with a prescription for a CPAP machine or related treatment
The Itamar WatchPAT-One home sleep apnea test is a fairly straightforward, user-friendly process – as long as you’re comfortable with telehealth and using apps.
You’ll start the process by ordering the test online and taking an online sleep assessment.
And, you’ll have a video chat with an independent, board-certified physician who decides whether you meet the criteria for at-home testing.
If he or she feels you could benefit from taking the test, your kit will be shipped out. Once it arrives, you can plan a night to take the test.
The Itamar WatchPAT-One kit includes a wrist-worn device, a chest sensor, and a finger probe. Taking the test requires a Wi-Fi connection and installing a connected app on your smartphone. The app will give you the instructions about how to apply the sensors to your body. During the night, you must keep your phone plugged in and within five feet.
The next morning, you use the app to end the test. The data from the device is downloaded within minutes and then uploaded to the cloud so that it can be reviewed by a doctor. You will receive a test report and have the opportunity to discuss the results with a sleep coach.
The cost of the test includes shipping of the device to your home. After you take the test, no return shipping is required and you can simply dispose of the device.
If your sleep report shows that you do have sleep apnea, the physician will provide a prescription for a CPAP machine or recommend other therapy as needed.
Patients rave about the customer support, from the time they connect with their Sleep Therapist to being available to answer questions about the test itself, to the convenience of not having to ship the test kit back. Overall, people were pleased with the timeliness of the shipments as well.
WHAT’S GREAT?
- Never have to leave home
- Telehealth visit with a doctor, plus phone support for any other questions
- FDA and DOT approved
WHAT’S NOT SO GREAT?
- Must be tech savvy (with Wi-Fi, a smart phone and using the app)
- You might feel more comfortable working with your own doctor
- Must be 18
Why is the Itamar WatchPAT-One home sleep apnea test the best overall?
The company is well-rated for its customer service and speedy process. It’s also convenient, and at a comparable price point to other similar tests.
Who should use the Itamar WatchPAT-One home sleep apnea test?
Anyone who suspects that they may have OSA because they snore, feel tired, or do not have access to or have to wait for a lab sleep study appointment may want to try it.
Interpreting At-Home Test Results
The interpretation of a home sleep apnea test is done by a doctor or sleep specialist. Although the device may provide preliminary results, the most in-depth interpretation occurs after your doctor reviews the results from your at-home test.
A key element of the test report is the apnea hypopnea index (AHI) or the respiratory disturbance or respiratory event index (RDI or REI). These summary measurements are an indication of the number of breathing-related sleep disruptions that you experienced per hour during sleep or during the total time of the test.
The doctor evaluates your symptoms along with your test results to decide whether you have obstructive sleep apnea. A diagnosis of OSA requires an AHI over 5 with symptoms or an AHI over 15 with or without symptoms.
In general, the following results are used to categorize obstructive sleep apnea:
- Normal: AHI under 5
- Mild sleep apnea: AHI of 5 to 14
- Moderate sleep apnea: AHI of 15 to 30
- Severe sleep apnea: AHI of 31 or more
Depending on the sensors used in your test, your test report may provide a list of other measurements and findings. If there were any device or sensor failures, you may receive a test report with an invalid or inconclusive result.
