When to Get a Polysomnography vs a Home Sleep Test

When to Get a Polysomnography vs a Home Sleep Test

It can be tough to decide which sleep apnea test is right for you. Should you opt for the cheaper, easier home sleep test? Do you qualify? When should you really opt for the polysomnography? What’s involved in that decision? 

We know that this can be a challenging set of questions to answer, so we want to make it a little bit easier. Depending on your symptoms and potential for sleep apnea or other sleep disorders, you can know which of these two sleep tests may be right for you. Before you decide to do one or the other, be sure to consult with your physician as they may have additional insights that could prove useful in your decision making process. 

When To Have a Polysomnography

Polysomnography is an in-depth sleep test that usually takes place in a hospital lab or off-site sleep clinic. The process requires at least one overnight stay--more if the data collected is insufficient. You will have dozens of pieces of data monitored by nodes attached to various parts of your body, including your head, nose, ears, chest, abdomen, and legs. 

There are a few conditions that really do necessitate an in-lab study. Some of these are insomnia, narcolepsy, and restless leg syndrome. These three conditions often go underdiagnosed because of their frequency as well as their fairly innocuous symptoms. Here are some symptoms you’ll want to watch out for if you think you may have these conditions. 


Insomnia is a condition where you are unable to sleep for long periods of time regardless of environment or level of exhaustion. Many may claim to have “insomnia” when they simply can’t sleep for one night, but the actual condition is much more serious and often involves a chemical imbalance in the brain. Symptoms for insomnia include: 

  • Problems falling asleep at night
  • Frequent nighttime wakefulness 
  • Waking up too early
  • Daytime fatigue or not feeling well-rested after a night’s sleep
  • Daytime exhaustion or sleepiness
  • Experiencing irritability, depression, or anxiety
  • Inability to focus, pay attention, or remember things
  • An increased tendency towards errors or accidents
  • Ongoing sleep worries

If you believe you have several of these symptoms, it’s imperative to talk to your doctor about a polysomnography. Because there are many potential causes for insomnia, it’s important that you get tested to see which is the root of your disorder so you can get appropriate treatment.


Narcolepsy is sometimes called the opposite of insomnia, but it’s much more complicated than that. This is a disorder characterized by sudden “attacks of sleep” that can cause the user to fall asleep spontaneously at anytime during the day or night, causing potential harm to the sufferer and those around them. It’s possible you may have narcolepsy if you experience any or most of the following: 

  • Excessive daytime fatigue or sleepiness
  • Sudden sleep attacks that come on without warning
  • Sudden loss of muscle tone
  • Sleep paralysis 
  • Significant changes in REM sleep
  • Hallucinations

Narcolepsy requires specific data that can only come from a polysomnography, so talking to your doctor to get a diagnosis for this is imperative to improve your quality of life. 

Restless Leg Syndrome (RLS):

RLS is a fairly rare condition that causes uncomfortable, sometimes painful, sensations in the legs before, during, and after sleep. This can be isolated in the legs or continue down to the feet. In few circumstances, it can even affect the arms. Talk to your doctor if you experience any of the following symptoms: 

  • Leg sensations that begin after you’ve rested, nappened, or slept
  • Relief with movement (i.e. walking, pacing, stretching)
  • Increased pain or sensations in the evening
  • Nighttime or late night leg twitching

Even if you haven’t experienced symptoms for these particular conditions, there are a few other situations where you may want to opt for an in-lab sleep study:

  • If you are under 18 years of age
  • Have COPD or any moderate-to-severe pulmonary disease
  • Congestive Heart Failure
  • You have a neuromuscular disease like ALS, Parkinson’s, MS, or Muscular dystrophy

When To Have a Home Sleep Test (HST)

Home sleep testing is an option for those who believe they may be at increased risk for obstructive sleep apnea (OSA). OSA is a condition where you can repeatedly stop breathing during sleep as a result of an obstructed airway. There are many potential causes for this condition, but, regardless of your cause, treatments are fairly consistent and highly effective. 

Benefits of HSTs

Home sleep testing is extremely beneficial for those who believe they may be suffering from sleep apnea, a fairly common disorder, as opposed to much more serious conditions like those outlined above. Home sleep tests are much more accessible, especially if you live in more rural areas away from advanced medical care facilities. 

HSTs are also much more cost effective, often about ⅓ to ½ the cost of in-lab sleep studies, and you receive your results much faster. Depending on your home sleep test provider, most will have your results back in 10-14 business days as opposed to 2 to 3 months for in-lab studies. 

Results & Likelihood of OSA

The time difference has much to do with the amount of data collected during testing. In home sleep testing, there are only a few pieces of data that determine if you are suffering from sleep apnea. For other conditions, like insomnia or narcolepsy, there are several more factors at play that require much more detailed and comprehensive testing--all of this means more time for analysis and diagnosis. 

If you’re wondering whether or not your are at risk for sleep apnea, you can follow this breakdown from Stop Bang


YES = 1 point  NO = 0 points

  • Snoring - Do you snore loudly?
  • Tired - Do you often feel tired, fatigued, or sleepy during the daytime?
  • Observed - Have loved ones noticed gasping for air, choking, or not breathing during sleep?
  • Pressure - Do you have or are you being treated for high blood pressure?
  • BMI - Are you obese/ very overweight – BMI more than 35 kg/m2?
  • Age - Are you age 50 or older?
  • Neck size - Is your neck Circumference >16 inches?
  • Gender - Are you male?

Add Up Your Score 

0 – 2 Points low risk of sleep apnea

3 – 4 Points intermediate risk of having sleep apnea

5 – 8 Points then you are at high risk of having sleep apnea

This short test is an easy way to see if you may be at increased risk of sleep apnea. If you score in either the intermediate or high risk categories, you should consult with you doctor or an HST provider about whether or not you should undergo testing for sleep apnea. 

Your Next Steps 

Sleep testing can be required for your job or simply the result of poor sleep over a long period of time. Either way, it’s extremely important to know what your sleep testing options are and which one may be right for you and your future health. 

Polysomnographies are important for diagnosing serious sleep conditions, and may be necessary if you suspect you may be suffering from any. However, home sleep testing is your most comfortable, quick, and cost-effective options if you’re concerned about sleep apnea. If you opt for home sleep testing, do research to ensure you have a reliable, proven home sleep test provider who will get you results and treatment as soon as possible. 

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