Should You Offer Multi-night Home Sleep Testing?

May 26, 2021

Summary of publication from Sleep Review Magazine, May 26 2021

Newer technologies make studying patients for more than one night easier than ever. What are the pros and cons?

Sleep is complicated, and many reasons could account for irregularities in sleep patterns from one night to another. From alcohol to sleeping position, even seemingly minor changes in a person’s nighttime routine can significantly impact the results of polysomnography.
Recently, researchers found single-night sleep studies could miss moderate and mild obstructive sleep apnea (OSA) up to 60% and 84% of the time, respectively. Another recent study published in CHEST, which examined 10,340 adults, found that monitoring just one night’s worth of data resulted in notable misdiagnoses in OSA severity. The study’s population was administered home sleep tests (HSTs) and found that collecting three night’s value of data “clearly provides an alternative for diagnosing sleep apnea that’s accessible for all healthcare professionals.”

Multiple-night sleep studies are hardly a new concept but haven’t been trending among providers, patients, or payers until recently. Here are some facts to consider:

What do your patients prefer and what do they want from this experience? Patient needs are very diverse. The flexibility to collect multiple nights of data can have tremendous benefits for the patient.

How many nights is enough?
The key challenges include analyzing the large amount of data collected, increased patient load with having to attach a device for many nights, storing and keeping the data, and evaluating how many nights are enough.

Single night HST can mean shorter diagnostic turnaround times for patients. Some severe sleep-disordered breathing are more adherent to treatment when wait times were shorter.

Many payers only reimburse for the first night and require a waiting period for a second night’s test to be eligible for reimbursement.

It’s a growing market and without a doubt more systems are offering features that will support multi-night testing. But to see this trend really take off, changes in reimbursement policies need to occur for the additional tests to make financial sense for both the patient and provider…