Sleep lab vs home sleep test: which one is right for you?

So you think you need a sleep test. Making the choice between a home sleep study vs lab might seem like a no-brainer — if you assume that a sleep lab is automatically more accurate. But while an at-home sleep test might feel like cutting corners, it's not. 

If your clinician suspects you have moderate to severe obstructive sleep apnea (OSA), a common sleep disorder that affects one in three adults in the U.S., a home test is a validated first step. Home testing can provide useful results without requiring an overnight lab stay, and the test is conveniently done right in your own bed. 

Learn more about the differences between home sleep studies and sleep lab tests, when each is the right clinical choice, and the next steps you can take to best identify your sleep problem.

Home sleep study vs. lab study at a glance

Get clear on the similarities and differences between at-home and in-lab sleep tests — and which one might be right for you:

What is a home sleep study?

A home sleep study is a test conducted in your own bed that measures data like airflow and blood-oxygen levels. Ordered by a physician or virtual sleep clinic, the test is shipped directly to your home where you will set it up and use it while you sleep.The Sunrise Sleep Test — an FDA-cleared at-home sleep test device — sits on the chin and measures mandibular jaw movement and blood oxygen saturation. With wireless data transmission, there are no cords to contend with, so set up is easy. 

For uncomplicated cases, the American Academy of Sleep Medicine (AASM) considers the home sleep apnea test to be an appropriate and acceptable alternative to in-lab polysomnography for OSA diagnosis. “For the right patient, home testing can provide enough information to diagnose OSA without requiring a more expensive and involved in-laboratory study,” says Katleen Denoncin, Head of Clinical Research & Medical Affairs, Sunrise Group.

Benefits of a home sleep study

• Comfort and setting: With a sleep test at home, “patients can sleep in their own bed rather than spending a night in a sleep laboratory, and the equipment is much simpler and less cumbersome,” says Denocin. What’s more, sleeping in a familiar environment while being hooked up to fewer sensors causes less disruption, so that the way you sleep during the test is more representative of real life, she adds.

• Convenience and speed: It doesn’t get any more convenient than getting tested from your own home. To check your eligibility for a sleep test through Dreem Health, you will first take a short, 3-minute assessment about your sleep habits, how long it takes to fall asleep, and how you feel when you wake up. After completing an intake form online and completing insurance details (or selecting self-pay), you’ll book your sleep health appointment and then the home sleep test device will be  shipped to you. You'll be on your way to better sleep in no time: “The time to be able to get an actionable plan in place is short,” says board-certified sleep, pulmonary, and critical care physician Alison Kole, MD, host of the podcast Sleep Is My Waking Passion.

• Cost and insurance: Price will vary depending on the sleep clinic and test, but an initial visit for the evaluation and the device itself may cost a few hundred dollars. Many companies like Dreem Health accept insurance and also self-pay or use HSA/FSA dollars. You can read more about insurance coverage and pricing with Dreem Health.

Limitations of a home sleep study

• Scope: A home sleep apnea test is designed to evaluate for OSA, not sleep disorders in general, says Denocin. While home testing can be a convenient way to diagnose moderate to severe sleep apnea in people without other complications, it is less sensitive than an in-lab sleep study and may miss milder cases.

• Setup: The test is self-directed. You will apply the device yourself, but it's not complex. Modern devices are designed for easy self-application. For example, the Sunrise Sleep Test device works by measuring jaw movement, airflow, and blood oxygen saturation while sitting on your chin, making it comfortable to wear.

Read more about what can a sleep study diagnose here.

What is an in-lab sleep study (polysomnography)?

An in-lab sleep study is a comprehensive test that measures airflow, brain waves, muscle electrical activity, eye movement, and more and can diagnose a full range of sleep disorders.

Although most people will be candidates for home OSA testing, if you have a suspected sleep disorder that’s not OSA, have a more complicated health history, or an at-home OSA test was inconclusive, then an in-lab test is the better option for you, says Dr. Kole.

Benefits of an in-lab sleep study

• Scope: Polysomnography is much more comprehensive, says Denocin. An in-lab sleep study can diagnose various sleep disorders, including narcolepsy, sleep walking, REM sleep behavior disorder, periodic limb movement disorder, central sleep apnea, and sleep-related hypoventilation. 

• Setup: The test is technician run. The sleep tech will hook you up to the testing equipment and can make adjustments as needed throughout the night.

Limitations of an in-lab sleep study

• Comfort and setting: An in-lab test is held in a sleep clinic. It’s set up like a bedroom with a private bed and bathroom. Despite efforts to make it comfortable, it’s still not your bed and you’ll be hooked up to wired sensors and observed overnight. 

• Convenience and speed: The process for insurance approval and securing an in-lab appointment can take a long time and more effort from the clinician and patient. Access is a huge issue, says Dr. Kole, as some people may need to travel long distances to get to a sleep lab. In addition, the turnaround time for results can be one to two weeks or up to a month, she explains.

• Cost and insurance: Insurance may ask you to jump through hoops to get prior authorization and coverage for in-lab testing. Average costs can range up to $3,000, though they may be more or less depending on your area and sleep clinic.

Read more about how sleep apnea testing works here.

Which test is right for you?

The main question is: Do your signs and symptoms suggest you have OSA? If so, a home sleep test is likely the right option for you; more complicated cases require a sleep lab test. 

A home sleep test is likely the right choice if: 

• • You have OSA symptoms or risk factors (or if your partner snores and you suspect they have OSA). Per the AASM, these include:

    • Snoring

    • Choking/gasping during sleep

    • Fatigue/daytime sleepiness

    • Obesity

    • High blood pressure

  • Women often experience less common symptoms of OSA, says Dr. Kole,  including: 

    • Insomnia

    • Difficulty maintaining sleep

    • Waking up a lot at night

  • You want to test quickly (without a potential long wait time)

  • A sleep lab is not located near you

An in-lab study is likely right if: 

• Your symptoms are complex and indicative of a non-OSA disorder, says Dr. Kole. These include:

  •  Having “sleep attacks,” 

  • Acting out your dreams

  • Kicking or punching in your sleep

  • Waking up with nightmares

• You have significant comorbidities, such as a history of severe insomnia, long-term opioid use, stroke, COPD, emphysema, or neuromuscular disease.

• A home test came back inconclusive or it was negative and you continue to experience symptoms.

The bottom line

A home sleep test is a simpler, cheaper, and more convenient tool for diagnosing OSA in appropriate individuals, while an in-lab sleep study is more comprehensive and preferable when an OSA diagnosis is uncertain, you have complicated medical conditions, or another sleep disorder is suspected, says Denocin. Continue reading about how Dreem Health’s at-home sleep study works. 

Frequently asked questions (FAQs) 

How many nights does a home sleep study take?

This depends on the home sleep study device you are using. While most tests analyze sleep over one night, the Sunrise Sleep Test can be done up to 3 nights if recommended.

Can I go to the bathroom during a home sleep study?

Yes, you can use the bathroom during an in-lab polysomnography or an at-home sleep test. 

What happens if you "fail" a home sleep study?

If your results are inconclusive or negative (but you continue to have symptoms or OSA is still suspected), your clinician may recommend an in-lab evaluation as an appropriate next step. 

Can a home sleep test diagnose anything besides sleep apnea?

A home sleep test is designed to diagnose moderate to severe obstructive sleep apnea (OSA). If another sleep disorder is suspected, such as narcolepsy or central sleep apnea, you’ll need to have an in-lab polysomnography (sleep test).