Home sleep apnea test: how it works, who it's for, and what it costs

How a home sleep test works

A home sleep apnea test lets you sleep in your own bed while a small device records how you breathe. AASM says these devices measure your breathing and blood oxygen, and some also track heart rate. You usually set it up yourself.

Devices differ in their sensors and how you wear them. You attach them at bedtime as instructed, and you may be asked to keep a short sleep log. Many tests record a single night; ask how many nights yours needs.

On test day, AASM suggests you keep to your routine, skip naps, and avoid alcohol and caffeine after lunch. Tell your doctor about any regular medicines. In the morning you take the sensors off and return the device, or throw it away if it’s disposable.

Who it’s for, and who needs a lab study

A home test is a good fit, per AASM, when:

• You’re an adult and it’s highly likely you have moderate to severe obstructive sleep apnea.
• You have no other significant medical conditions.

AASM’s guideline recommends a full in-lab study (polysomnography) instead if you have:

• Significant heart or lung disease
• Possible breathing-muscle weakness from a neuromuscular condition
• Low breathing while awake, or suspected low breathing in sleep
• Long-term opioid use
• A past stroke
• Severe insomnia

AASM’s patient guide adds two more: your doctor suspects another sleep disorder, or it’s hard for you to run the test at home. Cleveland Clinic notes a home test can’t diagnose central sleep apnea, and it doesn’t record brain waves.

These guidelines are for adults. A child who snores needs a pediatrician.

Who orders it and who reads it

A home test is a medical test, not a gadget. AASM’s position is that:

• A medical provider must order it after reviewing your history and examining you, in person or by telemedicine.
• It shouldn’t be used to screen people with no symptoms.
• A physician who is board-certified in sleep medicine, or overseen by one, must review the raw data. Automatic scoring alone isn’t enough.
• Only a medical provider can diagnose sleep apnea.

Results can take several days or weeks. If the test is negative but you still have symptoms, or it didn’t record enough data, AASM recommends an in-lab study. A negative home test doesn’t rule out sleep apnea.

What AHI means

Your report will likely give an AHI, the apnea-hypopnea index. Cleveland Clinic defines it as the average number of breathing pauses and shallow-breathing events per hour of sleep:

• Mild: 5 to 14 per hour
• Moderate: 15 to 29 per hour
• Severe: 30 or more per hour

Your physician will explain what your number means for treatment. See snoring or sleep apnea? for the symptoms behind the numbers.

What it costs and why

Prices vary a lot, and we haven’t found a national figure from a government or medical society. The one range we found comes from CareCredit, a health credit card company, citing a sleep medicine provider.

It says an at-home test typically costs $300 to $600, and in-lab studies $500 to $3,000. Its source is a sleep clinic’s blog, accessed in 2024. It doesn’t make clear whether these are prices before or after insurance.

What drives your cost:

• The visit that leads to the order. In person or by video, with a physician or other medical provider.
• The device. Reusable kits you return, or disposable ones.
• The physician’s reading. Scoring and interpreting the data is a professional service.
• Your coverage. Deductible, copay, and whether the provider is in network.
• Follow-up. A second test, or a lab study if the home test is inconclusive.

A home test usually costs much less than a night in a sleep lab. But if you’re likely to need a lab study anyway, testing at home first can mean paying twice.

What insurance covers, and what it doesn’t

Medicare. Medicare.gov says Part B covers Type I, II, III and IV sleep tests when you have clinical signs and symptoms of sleep apnea. After the Part B deductible, you pay 20% of the Medicare-approved amount. Type I tests have to be done in a sleep lab.

Private insurance. CareCredit notes that most health plans may cover sleep studies if you meet the plan’s criteria. What you pay depends on your deductible, copay, and whether the provider is in network. Ask whether your plan needs prior approval, and whether it wants a home test before a lab study.

Online test services. Some bundle the order, the device and the physician’s reading for one price. Ask whether they bill insurance or take HSA or FSA cards before you pay.

Questions to ask

1. Is a home test right for me, or do my health conditions call for a lab study?
2. How many nights will the test record, and what sensors will I wear?
3. Who reads my results, and is that physician board-certified in sleep medicine?
4. How will I get my results, and who explains them?
5. If the test is negative or doesn’t record enough data, what happens next, and what does that cost?
6. Will you bill my insurance? What will I owe after my deductible?
7. If I have sleep apnea, can the same provider help me start treatment, such as CPAP Strong or a custom oral appliance Some?