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Key criteria for selecting the right home sleep testing device for your practice, including physiological data requirements, ease of use, and clinical validation.
Selecting the right home sleep testing (HST) monitor for your practice
The diagnosis and treatment of Obstructive Sleep Apnea (OSA) is undergoing a paradigm shift particularly regarding home sleep testing (HST). Supported by organizations like the American Academy of Sleep Medicine (AASM)1 and many insurance companies, home sleep assessment is witnessing adoption by practitioners and patients alike as it can facilitate easier access to specialized care and improve patient quality of life.
There are a number of portable monitors that can be used in home sleep testing as a baseline evaluation, or to evaluate the efficacy of OSA treatment whether that’s OA, CPAP, or others. Here’s some important criteria for selecting a portable sleep monitor for your practice:
Recording of Proper Physiological Data:
The American Academy of Sleep Medicine (AASM) outlines the proper OSA evaluation as recording at least:
• Airflow (pressure-based)
• Pulse oximetry
• Heart rate
• Respiration effort measured via Respiratory Inductive Plethysmography (Type III monitor).
Other parameters that are strongly recommended are snore, temperature-based airflow (thermistor) for apnea confirmation and body position for positional apnea estimation. Some devices also record muscle activity (EMG channel), which could be of particular help to dentists during OA titration since it can evaluate bruxism.
Ease of Use:
A small, lightweight system allows for easy self-administration at home without the need for a sleep technologist.
The home sleep test requires wrapping a RIP belt around the chest, placing and securing a pulse oximeter on the patient’s index finger, and wearing a nasal cannula, all minimally invasive.
A thermistor can be used along with the nasal cannula to confirm apneas. Data quality is assured as the portable sleep monitor is designed to indicate proper placement of the sensors through light and sound indicators.
The monitor includes an automatic check for validity before the patient goes to sleep, enabling a fast way to repeat the study if needed in the event there’s a disconnected sensor.
Choosing the right portable sleep monitor that offers ease of use for the patient, and appropriate sleep lab methodology for the physician, is the first step in deploying Home Sleep Testing the right way.
References: 1. Collop N, Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2007 Dec 15;3(7):737–747.