Home Based Tests - Evaluation Of Sleep Disturbances: Sleep Disorders

Content provided by the Faculty of the Harvard Medical School

Home-based tests

Some sleep-monitoring equipment can be used at home. Physicians, however, disagree about whether the information collected is reliable enough to use for diagnosis and treatment. Portable recordings may be useful when polysomnography is not available and symptoms indicate that immediate treatment is needed, or when a patient is bedridden or medically unstable and cannot be moved. Home-based tests may also be used when a physician wishes to evaluate the effectiveness of treatment.

Apnea detectors. To detect breathing disturbances during sleep, a patient is sometimes equipped with apnea detectors that can measure heart rate, snoring sounds, body position, nasal airflow, and the amount of oxygen in the blood. Although these devices have been used to estimate how many people suffer from breathing disturbances, the information they provide isn't as accurate as sleep lab evaluations and may not be complete enough to diagnose and plan treatment for an individual. Most experts believe a sleep lab evaluation is required.

Wrist actigraphy. A wristwatch-sized monitoring device that automatically records arm or leg movements can be used to track periods of sleep and wakefulness at night. Although it cannot determine the stage of sleep, it can help clarify ambiguous aspects of a sleep diary — such as entries reporting long hours of sleep but exhaustion the next day — or assess the effectiveness of medical treatment. The actigraphy device may reveal that brief awakenings during the night are unknowingly disturbing sleep. In some studies, wrist actigraphy accurately determined whether a person was asleep almost 90% of the time.

The American Academy of Sleep Medicine recommends polysomnography as the best method for diagnosing sleep apnea and determining its severity. Portable home devices can miss mild apnea and other sleep disruptions, and they don't provide the sleep stage information that's needed to rule out other sleep disturbances. Accordingly, they should only be used when the patient's physician is familiar with the devices' benefits and limitations and has experience interpreting the results.

Last updated:	January 23, 2007