Home Sleep Apnea Testing: American Academy of Sleep Medicine Position Statement
The use of HSAT devices is not supported in asymptomatic adults or children.
The American Academy of Sleep Medicine (AASM) has published a new position statement on the clinical use of a home sleep apnea test (HSAT) in the Journal of Clinical Sleep Medicine.
HSATs are ordered by healthcare providers to help diagnosis obstructive sleep apnea (OSA) in adults. If left untreated, OSA can increase the risk of hypertension, heart failure, type 2 diabetes, and stroke. The AASM states that polysomnography is the standard medical test to diagnose OSA when it is suspected in adults. On the other hand, an HSAT serves as an alternate clinical test to diagnose OSA in uncomplicated adults presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. HSATs are less sensitive than polysomnography tests in detecting OSA but can be ordered for select adult patients.
The use of HSAT devices in screening asymptomatic adults or children, however, is not supported due to insufficient data.
The new statement includes the following key positions:
- Only a physician can diagnose medical conditions such as OSA and primary snoring.
- The need for, and appropriateness of, an HSAT must be based on the patient's medical history and a face-to-face examination by a physician, either in person or via telemedicine.
- An HSAT is a medical assessment that must be ordered by a physician to diagnose OSA or evaluate treatment efficacy.
- An HSAT should not be used for general screening of asymptomatic populations.
- Diagnosis, assessment of treatment efficacy, and treatment decisions must not be based solely on automatically scored HSAT data, which could lead to sub-optimal care that jeopardizes patient health and safety.
- The raw data from the HSAT device must be reviewed and interpreted by a physician who is either board-certified in sleep medicine or overseen by a board-certified sleep medicine physician.
While an HSAT can provide data to assess certain adults with OSA, "the test is only one component of a comprehensive sleep evaluation, and it is important for a board-certified sleep medicine physician to be involved in reviewing and interpreting the raw data from the device," added AASM president, Dr. Ilene Rosen. Prompt and accurate diagnosis of OSA along with effective therapies can "improve health, promote public safety, and reduce overall healthcare expenses."
Rosen IM, Kirsch DB, Chervin RD. Clinical use of a home sleep apnea test: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2017;13(10). doi:10.5664/jcsm.6774