Sleep conditions such as sleep apnea are now such a common problem that there is an increased need for sleep studies and sleep-related primary care.
There are also now many home sleep studies that can be bought online. However, although taking the test itself might seem straightforward, understanding the results is a whole new ball game.
Making sure you fully understand your results is vital because reading incorrectly could lead to a misdiagnosis.
So, in this guide, I will give you an easy way to read and understand your sleep study scoring results.
When is a Sleep Study Needed?
Sleep studies, also known as Polysomnography or PSG, have been used for decades to determine the cause of sleep apnea and measure the level of breathing disturbance during hours of sleep.
Over the last couple of decades, there has been an increased need for sleep studies due to a rise in sleep conditions and people being more aware of what the condition means.
Sleep breathing disorders are now estimated to affect 3% of women between 30 and 49, 9% of women between 50 and 70, 10% of men between 30 and 49, and 17% between 50 and 70. This tells us that men of the older generation are more severely affected.
Sleep breathing conditions such as sleep apnea can be a severe problem and can even be life-threatening in some cases if left untreated, which is why you must get an early diagnosis.
If you think you are suffering from a sleep condition, speak to your doctor, who will perform the initial assessment of your general sleep hygiene and an ESS (Epworth Sleepiness Scale), which measures your general sleepiness during the day.
Depending on the results of these tests, if necessary, they will refer you to a sleep specialist.
What Happens During a Sleep Study?
During the initial ESS study, you will be asked a series of questions, such as how likely you are to fall asleep during specific scenarios.
Overall, the study is scored between 0-24, and anything above 16 is considered a severe sleep condition that will require further investigation. This result will be compared with your PSG score, which will help to determine whatever sleep disorder you may have.
Your doctor will also ask you about your daily life and habits, such as caffeine consumption, diet, activity, and whether or not you drink alcohol or smoke.
They will also ask you about your sleeping environment and discuss the best way to try and improve your sleep schedule.
If your doctor thinks you might have insomnia, a sleep study may not be needed. Instead, they will discuss with you what could be causing insomnia, such as medications or stress. Insomnia can also be a knock-on effect of other underlying medical conditions.
However, if your condition seems connected to your breathing, this indicates sleep apnea, in which case you will be sent for a PSG test.
After completing your studies, the results will be sent to your doctor, along with a course of recommended treatment.
Sleep Study at Home
There are now some sleep studies that you can do at home yourself. This is also a more cost-effective way to test and means you will not have to be on a waiting list.
Although I suggest visiting your doctor if you have any concerns about yourself, some people may feel more comfortable doing it in the comfort of their own homes.
The home testing kit is a portable device that you wear overnight to measure your breathing. During the night, the device will measure your oxygen levels and breathing pace (apneas.)
The test will measure the severity of your obstructive sleep apnea (OSA) by calculating the average number of lapses in your breathing during each hour you are asleep.
Of course, the most accurate way to get a diagnosis is by having your sleep study done via polysomnography in a lab. Remember that at-home testing kits are going to be less accurate than one done in a professional environment.
Sleep Study Report – Getting Your Results
So, once you have taken your at-home sleep study test, you will send off your test for analysis and wait for your results. However, once they arrive and you see all the complicated words and numbers, you might wonder what it all means.
This step-by-step guide to reading your results will make things simpler for you to understand. I will also explain what the diagnosis means and what would be the following steps to take.
Your test results will contain much different information, including your medical history, current medications, vitals, and a description of your symptoms. It may also include an overview of the diagnostic testing protocols used during your evaluation.
Reading Your Sleep Score
When you first receive your sleep study results, the first thing you want to look for is the AHI. This is the Apnea-Hypopnea Index [9]. Basically, this is an hour-by-hour index of your sleep apnea episodes that you recorded during your sleep study.
The AHI determines the severity of your breathing disturbances while you sleep. Here is what the numbers mean:
| Severe Sleep Apnea | 30.0 AHI or above |
| Moderate Sleep Apnea | 15.0 – 30.0 AHI |
| Mild Sleep Apnea | 5.0 – 15.0 AHI |
| Normal Indications of Sleep Apnea Episodes | Under 5.0 AHI |
Different Types of Sleep Apnea
Your test will also be able to help differentiate the type of sleep apnea that you have. This is determined by the frequency of breathing disturbances and the type of episode. However, it is common to experience sleep apnea without being diagnosed with that form.
1. Obstructive Sleep Apnea
Obstructive sleep apnea is diagnosed if the airways are blocked 90% or more and lasts longer than ten seconds. This happens because the upper airway and throat muscles become relaxed, blocking the passage. This is the most common form of sleep apnea and is usually caused by an obstruction in the airways.
2. Hypopnea
Hypopnea, or shallow breathing, is also caused by the relaxation of the throat and upper airways. This is diagnosed if the airway restriction is between 30% and 89% and the airflow is restricted for longer than ten seconds.
3. Central Apnea
Central apnea is similar to obstructive sleep apnea, except, in this case, there is no physical obstruction. Instead, the total loss of airflow is caused by neurological or pulmonary dysfunction, which lasts for ten seconds or more.
This is quite a rare condition often seen in patients with a problem with alcohol or opioid abuse or cardiac or neurological conditions.
4. Mixed Apnea
Mixed apnea, as you probably already guessed, is a combination of central and obstructive sleep apnea.
This complex condition is often seen in patients who suffer from a severe form of obstructive sleep apnea and have symptoms of central sleep apnea. To get this diagnosis, the episodes will last more than ten seconds.
Other Causes For Sleep Apnea
In some cases, sleep apnea is caused because of sleeping position. For example, people who sleep on their back may find that their sleep apnea and snoring are worsened due to gravity.
If your sleep score results show that your sleep apnea is position dependent, then they will talk to you about different positions to sleep in to control the problem.
If your sleep apnea is not due to your positioning, you will need further consultations to discuss your treatment. These include CPAP machines, nasal sprays, otolaryngologic surgery, or mandibular dental devices.
Conclusion
You must have a clear understanding of your sleep study results. A misunderstanding could lead to a misdiagnosis, which can be life-threatening should your actual condition go untreated.
Addressing any issues with your sleep conditions early on means that you can be treated before the situation worsens. An early diagnosis can also mean a chance of curing or improving your condition before it becomes more severe.
Sleep apnea can have a negative impact on your day-to-day life and can even start to affect your concentration at work. This is why getting tested for sleep conditions is crucial as soon as you notice the symptoms.
There are pros and cons to taking at-home sleep scoring kits. For example, they make you feel more comfortable, are more affordable, do not have to wait for them, and are convenient. However, they need to be more accurate and can lead to a misdiagnosis.
Lastly, it is essential to remember that many forms of sleep apnea and conditions can cause sleep disturbance, so always seek advice from a medical professional if you are uncertain or concerned about your symptoms.
