A Tale of Two Tests
Severe fatigue. That's the only way I could describe to my physician the symptoms I was feeling over the past few months. Sleeping 10 hours at night; napping on the weekends. Yet, I was never rested. As the editor of a respiratory website, I've read plenty about sleep apnea, and I've been warned by family members that I snore, so I suggested this diagnosis to my physician. After discussing my symptoms and the condition, he brought up the topic of home sleep testing. I was desperate and thought that if I could get a diagnosis, this fatigue could be controlled. Sign me up.
I picked up my kit from the physician's office, which was supplied from a home testing company. The representative was a nurse practitioner who was very thorough in showing me how to set up the kit at home and accurately test my sleep patterns. For three nights I hooked myself up and basically just went to sleep. It was simple to use and after dropping my kit back at the physician's office, I had answers within about a week. Results: no sleep apnea.
As a patient who has used this type of testing, I'm somewhat confused by how in-lab specialists react when asked about home sleep testing and boldly label in-lab tests as the gold standard. To these healthcare professionals, it almost seems like home sleep tests are irresponsible and a disservice to the patient.
Before writing this editorial, I remember a friend of mine who had an in-lab sleep study done some years ago, so I wrote her and asked what her experience entailed.
"I arrived at the site of the sleep study a bit nervous about being expected to sleep in a strange room and knowing this sleep was going to be evaluated. The entire situation seemed impossible. How can you get a good night's sleep in a strange place while being nervous that the quality of that sleep is being evaluated?" she noted.
Not only was she nervous about the study, but she also didn't care much for tromping around in her pajamas so she could get probes and gadgets attached to her. "What made it more discombobulating was the fact that by the time they finished you looked like Frankenstein with your hair full of goop, sticking straight out in places, and these probes sticking out of your body and head. Where I went for my study was at a prestigious university-run center, but I am surprised they did not provide private curtained areas where this process could be done.
"When I went for my study the only option was to have it done at the sleep center. I think I would have had an entirely different attitude toward the study had I been able to do it at home."
She did note one benefit of her in-lab sleep study: "When I went for my second study, I was fitted for a CPAP mask and went to sleep. I woke in the middle of the night because the mask was falling off. The technician then fitted me with a children's size mask and I fell asleep for about a half hour more and then woke feeling constricted because that mask was too tight. That was an advantage of being right there and having several sizes of masks available."
Unfortunately, due to her experience, she never did get a CPAP system. "I was so upset by the entire process I never pursued it."
Now, no doubt there are people who need in-lab sleep testing, especially those in staying in a hospital environment or perhaps older individuals who would have difficulties with accurately setting a home sleep test. But what I find most interesting is this divide that separates sleep professionals, one that can no doubt bring about confusion to both patients and other healthcare professionals in the care of sleep disorders. The future of healthcare holds many changes, and I believe being open to new technology and solutions is the first step in improving the health of future patients.
What are your thoughts about home sleep testing versus in-lab testing? Send me your thoughts. I want to learn more about this growing field.