What Type of Sleep Study Is Best for My Patient? Comparing Home vs. Lab

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Is There an App for That?

Patients have more choices than ever before to monitor their sleep quality and other health data without a prescription. Over-the-counter apps and wearable devices can record the intensity or frequency of snoring, blood pressure, breathing, heart rate, and body temperature. Hundreds of consumer wearable oximetry devices or free smartphone apps may record snoring intensity or possible breathing stoppages during sleep that may suggest OSA.

According to the American Sleep Association’s website, smartphones may one day include external sensors to collect more health data from the user’s body, including continuous oximetry readings to detect possible OSA. Currently, phones use heart rate to measure pulse oximetry. Future apps may include more accurate tests that send data to a sleep center or physician.

“Sensors have become widely available. They’re now made with cheaper, more user-friendly technology. They may provide interesting data, such as your heart rate, blood pressure, or oxygen levels, but there’s a lot of variability. I check my smartwatch data from the day before. These devices still need more scientific validation, but many clinical trials are already underway,” said Robson Capasso, MD, chief of sleep surgery and associate professor of otolaryngology-head and neck surgery at Stanford University School of Medicine in Stanford, Calif. He believes that apps and devices are part of a trend toward value-based healthcare and make health data more accessible to patients.

But these data only tell part of the story when it comes to sleep.

Some otolaryngologists are concerned that patients may try to self-diagnose OSA with an over-the-counter device or app instead of seeing a clinician for a prescription sleep study. These tools aren’t validated for use as diagnostic tools, said Edward M. Weaver, MD, MPH, professor of medicine in otolaryngology-head and neck surgery and chief of sleep surgery at the University of Washington School of Medicine in Seattle. “It’s unclear how well they measure sleep under ideal conditions, let alone under real-life conditions. One other concern with self-diagnosis is that other important health issues may be mistaken for sleep apnea, such as obesity, hypoventilation syndrome, or central sleep apnea. These warrant other testing and/or treatment.”

“Your diet, whether you’ve been drinking that evening, your sleep position, or recent weight loss or weight gain can make the results vary as well,” said Dr. Capasso. “Some patients may think about their sleep quality too much and become excessively concerned. It’s important for patients not to over-catastrophize about their health based only on their smartphone.”