At-Home Sleep Apnea Testing
Posted 3/28/2018 by UHBlog
One of the most common sleep disorders – obstructive sleep apnea – is now easier to diagnose with at-home tests. Ask us who the right candidates are for this test.
The quality of your employees' sleep is important to your company's bottom line. Excessive daytime sleepiness (EDS) affects nearly one-fourth of all U.S. workers, according to American College of Occupational and Environmental Medicine (ACOEM). The ACOEM study estimates that EDS-related disorders cost employers nearly $63.2 billion per year in medical expenses and lost productivity. Additionally, EDS can make an employee more likely to cause an accident or injury.
Although many factors cause EDS, one of the most common is obstructive sleep apnea (OSA). OSA occurs when your breathing starts and stops during sleep. It's a serious health risk, affecting up to 18 million Americans, including children. According to the American Sleep Apnea Association, about 80 percent of OSA sufferers go undiagnosed, increasing their risks of developing chronic diseases and the likelihood they'll harm themselves or others.
Many employers turn to home sleep apnea tests to diagnose OSA, according to occupational medicine specialist Mundeep Chaudhry, MD. While the at-home tests can be done at a lower cost than a polysomnography (PSG) – a sleep study test done in a medical setting – they have their limitations.
“A home sleep apnea test isn't suitable for all people,” Dr. Chaudhry says. “They aren't as sensitive as a PSG, which provides a lot more information. And in cases where the person has certain medical conditions, such as chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF), they should have an in-lab (PSG) sleep study.”
The home test usually includes devices to measure the person's breathing and blood oxygen level. Some tests also measure the heart rate or other information. Like a PSG, home tests should be read by an experienced sleep medicine doctor.
When determining whether a home test is right for your employees, there are benefits and drawbacks to consider, including:
- Likelihood the person has OSA. “The home test is appropriate for people who have a high risk of having moderate to severe obstructive sleep apnea,” Dr. Chaudhry says. “If there is significant risk that the patient has mild sleep apnea, then an in-lab PSG is recommended.”
OSA sufferers tend to be
- In families where other members have had OSA
- Someone with a smaller chin, thicker neck or who has some physical abnormality in the nose, throat or other parts of the upper airway
- An allergy sufferer or who has a condition that causes congestion
- Someone with medical conditions such as diabetes, high blood pressure, heart failure and/or COPD
- Someone whose lifestyle choice plays a role, such as smoking and alcohol before bedtime
- The type of work the employee does. Certain professions require screening for sleep apnea; for instance, commercial truck drivers and airplane pilots, or other jobs that involve safety sensitive work.
“For various reasons, a home study is less accurate if it is being ordered for employment purposes against the employees will,” Dr. Chaudhry says. “A good candidate is someone who is having a sleep problem and wants a solution. Home testing is more accurate in this situation.”
- Trustworthiness. “In home testing, there is no way of verifying who did the test,” he says. “Some people may try to game the system.”
In industries such as truck driving, where sleep testing is necessary for drivers who meet certain criteria, Dr. Chaudhry will order a home study in order to minimize costs for the driver. However, he tells the driver upfront that if the home study comes back normal, an in-lab PSG will need to be performed to verify the results.
If the home sleep apnea test indicates the person has untreated OSA, they can take steps to get it under control. In general, this includes using a continuous positive airway pressure therapy (CPAP) machine to resolve the sleep apnea. If the cause of the EDS is found to be something else, working with a sleep specialist can help to resolve the problem.
To learn more about University Hospitals' occupational health and safety services, connect with University Hospitals Employer Solutions for more information.
Mundeep Chaudhry, MD is an occupational medicine specialist for University Hospitals Occupational Health. You can request an appointment with Dr. Chaudhry or any other doctor online.