Home Sleep Testing (HSAT)
Home sleep testing (HSAT) has been gaining increased use over the last 5 yrs due to its cost advantage for insurance companies over in-Facility
Sleep Tests (PSG). This has led to confusion as to when to do a HSAT and when not to. Below are the pro’s and cons for the HSAT test.
Home sleep test (HSAT)
1) Pro’s
a) It is done at home. This can make the patient feel more comfortable.
b) It is easier to get the study approved through the insurance company since it costs them less money.
c) The test can usually be performed more quickly since there can be a wait for a in-facility bed spot to open.
2) Con’s
a) The HSAT can only tell whether obstructive sleep apnea is present or not. It can’t measure other causes for fragmented/poor quality sleep.
b) It has a 20% false negative rate for obstructive sleep apnea.
c) Even with instructions, patients can be confused on how to put on the equipment at night. This can require multiple nights with the equipment.
d) It is contraindicated in the follow situations
1) Patients 18 years old or younger
2) Moderate or severe COPD
This means patients with a pulmonary function test with a FEV1/FVC less than 0.7 and a FEV1 less than 80% of predicted.
3) Moderate or severe CHF – New York Heart Association class III or IV.
4) Cognitive impairment resulting in inability to apply the home sleep testing equipment.
5) Oxygen dependency for any reason
6) Stroke (CVA) within the last 30 days
7) Current use of opiate narcotics
8) Body Mass Index (BMI) over 33
9) Elevated serum bicarbonate level>28 mmol/L
10) Established diagnosis of obesity hypoventilation syndrome