Sleep Technology: Why Portable Sleep Monitoring Devices Won't Replace Sleep Centers

What are portable sleep monitoring devices? 

OSA or obstructive sleep apnea is one of the common sleep disorders affecting millions of people in the United States. It is characterized by restless sleep, morning headaches and fatigue, and snoring, among other symptoms. If left untreated, OSA can even increase the risk of hypertension, respiratory and cardiac conditions, and stroke. The gold standard for diagnosing this condition is polysomnography in sleep labs, though home sleep tests (HSTs) are also used for diagnosis. A home sleep test typically uses portable sleep monitoring devices for evaluating this sleep apnea.

A portable sleep monitoring device measures the heart rate, oxygen saturation, air-flow, and records position and snoring. If the sleep test is performed in a lab, the same factors will be measured, but additionally, the sleep time, leg movements and brain waves will also be recorded. A portable sleep monitor is light, non-invasive and user-friendly. The data that is generated from the test using the monitoring device is used to diagnose the prevalent condition followed by medical solutions from the sleep specialist.

Examining the pros and cons of portable sleep monitors and sleep labs

A home sleep test has become an alternative diagnostic methodology for reviewing sleep data. The data recorded in home sleep tests and polysomnography (PSG) conducted in labs is examined in the same way. The correlation in the results between these two methods has also found to be good in quite a few cases. Does this mean that a PSG can be entirely replaced by a portable sleep monitor-driven home sleep test? Here’s an examination.

Advantages

The most obvious advantage of a portable sleep monitoring device is that it allows the diagnosis to take place in the comfort of the patient’s home. The less instrumentation involved and the natural and familiar sleeping environment are also welcome advantages.

A home sleep test using a portable sleep monitor works out cheaper than an overnight stay at a sleep center.

Drawbacks

One of the disadvantages of a home sleep test using a sleep monitor is the fact that the patient has to take a proactive role in using the device. Some patients may not be comfortable with this and face technical issues. Without the presence of an attendant, the sleep test may end up being a failure, and the patient may have to re-take it.

Advantages and disadvantages of sleep centers over home sleep tests

If a patient’s differential diagnosis includes other kinds of sleeping disorders like narcolepsy or insomnia, then the best diagnostic test is a polysomnogram. The EOG and EEC monitors used in a PSG record cortical arousals and sleep states, both of which are unnecessary for diagnosing OSA but critical for other forms of sleep disorders. The presence of a technician at all times for equipment monitoring is another advantage of sleep labs. 

The cost factor figures prominently in an otherwise short list of sleep lab disadvantages. Not all patients can afford the costs of staying in a sleep lab for the duration of time needed to perform the test. The long waiting periods typically associated with sleep labs and the unfamiliar environment are other pros of diagnostic testing in sleep labs.

A performance comparison

For OSA conditions that range from moderate to severe, the diagnostic accuracy of portable sleep monitoring devices is good. Studies have indicated that level 3 and level 2 portable sleep monitors measuring three or more parameters offer accurate results in reference to lab polysomnograms. But there is a fall in diagnostic accuracy for level 4 portable monitors that measure two or less than two parameters. Portable sleep technology may also not be a good option when comorbidity exists, i.e. one or multiple disorders prevail alongside the primary disorder. The bottom line is that portable sleep monitoring devices cannot entirely replace sleep centers.

How to leverage sleep technology to increase business and referrals

Sleep centers that offer overnight diagnostic testing services should consider including home sleep testing where the necessary portable sleep testing equipment is made available to patients. By providing this option, sleep centers can target patients who cannot afford to or feel ill at ease spending the night in unfamiliar surroundings, even if it is for a medical test. The costs of renting the equipment can be included in the overall charges, with other terms and conditions in place to safeguard against loss or theft at the patient’s end. 

Setting up satellite operations comprising smaller labs away from the main center can help generate additional referrals but pose a financial challenge in terms of set-up as well as operations. A home testing service using portable devices in such cases is a financially wise decision.

Sleep labs can leverage portable sleep technology to expand their services to employer markets. Portable monitoring devices are practical solutions for sleep centers looking to offer diagnostic and screening services to shift workers and commercial drivers.


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