Sleep is essential to your overall health, but many people live with sleep disorders that go undiagnosed. Loud snoring, daytime fatigue, trouble falling asleep or unusual movements during the night can be signs of sleep apnea, insomnia, restless leg syndrome or narcolepsy. Left untreated, some sleep disorders can increase your risk of high blood pressure, heart disease, stroke and other serious health problems, all while affecting your mood, memory and quality of life. A sleep study can be an important tool in understanding what happens while you sleep and identifying possible sleep disorders.
How do I know if I need a sleep study?
Your doctor may recommend a sleep study if you have symptoms that could be related to a sleep disorder or if your sleep concerns are affecting your health or daily life. You could benefit from a sleep study if you:
- Snore loudly or have pauses in your breathing while you sleep
- Wake up gasping, choking or feeling short of breath
- Feel excessively tired or sleepy during the day, even after a full night’s sleep
- Have trouble falling asleep or staying asleep without a clear cause
- Experience unusual movements or behaviors during sleep, such as sleepwalking or acting out your dreams
- Have uncomfortable sensations in your legs that make it difficult to fall asleep
- Have a partner who notices concerning changes in your breathing or movement while you sleep
What’s a sleep study?
A sleep study is a diagnostic test that monitors your body while you sleep to help identify sleep disorders such as sleep apnea, insomnia, restless leg syndrome and parasomnia.
During the study, small sensors are placed on your skin to track different aspects of your sleep, including brain activity, breathing, heart rate, oxygen levels, muscle activity and movement. The test is painless and typically takes one night to complete.
The information collected during the study gives your doctor a clearer picture of your sleep patterns and helps guide recommendations for treatment. Depending on your symptoms and medical history, your sleep study may take place at a sleep center (in-lab) or, in some cases, in your own home.
Will my sleep study be covered by insurance?
Yes, sleep studies are typically covered by most insurance plans, especially if they're medically necessary. However, coverage can vary depending on the insurance provider and the type of sleep study (in-lab or home sleep apnea test). It's important to check with your insurance company to confirm coverage details and any out-of-pocket costs, such as deductibles or co-pays.
Before scheduling your sleep study, it's a good idea to:
- Verify with your doctor or sleep specialist if the study is covered under your plan.
- Contact your insurance provider to ask about coverage, pre-authorization requirements and any costs you may need to pay.
- Some insurance plans may require a referral or documentation from your primary care physician before approving the study
What should I expect during an in-lab overnight sleep study?
Before your sleep study, we take several important steps to make sure everything goes smoothly and we gather the most accurate information to help with your diagnosis.
Before your sleep study:
- After we receive your referral, our team reviews your medical records.
- We handle any insurance authorizations that may be required.
- Once everything is approved, we'll reach out to schedule your sleep study.
How should I prepare for my sleep study?
Before coming to the sleep center:
- Wash and dry your hair
- Don't use hair spray, oils, gels, lotions or creams—your hair and skin should be clean and dry
- Pack an overnight bag, like you would if staying at a hotel
- Notify the center if you're on oxygen at home
- Bring your CPAP mask and headgear if you use a CPAP machine at home (no need to bring the machine)
- Avoid caffeine after noon on the day of your study
- Avoid napping on the day of your study
Important note: Continue taking your prescribed medications unless your doctor gives you different instructions and be sure to let our team know what medications you take, as some can affect sleep study results.
What to bring:
- Your medications
- Loose-fitting two-piece sleepwear
- Comfort items like blankets or pillows
- Any snacks and drinks since food isn't provided
The day of your sleep study:
When you arrive at the sleep center, a sleep technologist will welcome you and guide you to your private room. While the technologist prepares the equipment, you can change into your sleepwear and relax. You can use our Wi-Fi or watch TV during this time, and you may have some paperwork to fill out.
Your sleep technologist will help you get settled, explain what to expect during the study and answer any questions before placing the monitoring equipment:
- Small sensors are placed on your scalp and face to monitor your brain activity, eye movements and muscle tone
- Small electrodes are placed on your chest to monitor your heart rhythm
- Elastic belts are placed around your chest and abdomen to measure your breathing effort
- A small sensor is placed near your neck to monitor snoring
- A soft nasal cannula is placed under your nose to monitor airflow
- Sensors are placed on your legs to monitor leg movements during sleep
- A small finger probe monitors your oxygen levels and heart rate
During the night:
The setup process usually takes about 30 to 40 minutes. Once everything is in place, you can go to sleep when you're ready. To meet insurance requirements, sleep studies generally need at least 6 hours of recorded sleep.
You'll be able to move and change positions throughout the night. Your sleep technologist will monitor the study from a nearby room and can assist if a sensor needs adjustment or if you need to get up during the night. Most patients wake up at least once to use the restroom. Most studies finish between 5:30 and 6 am
After the sleep study:
Your sleep study results will be carefully reviewed by a registered sleep technologist and interpreted by a board-certified sleep medicine physician. They will develop a comprehensive report and send it to your sleep clinician, who will review the results and discuss any treatment recommendations with you during your follow-up appointment.
If you don't already have a follow-up visit scheduled, you should contact your clinician’s office after your sleep study to arrange one.
If your study included CPAP titration, your clinician may send a prescription to a durable medical equipment (DME) company, which will contact you to arrange for your CPAP equipment and provide education on its use.
Quick guide to common sleep disorders.
- Insomnia: Ongoing trouble falling asleep, staying asleep or getting enough restful sleep can affect your overall health and well-being.
- Parasomnia: Sleep behaviors such as sleepwalking, night terrors or acting out dreams can disrupt your sleep and sometimes pose safety concerns.
- Restless leg syndrome: Uncomfortable sensations or an urge to move your legs that make it difficult to fall asleep or stay asleep can often be managed with the right treatment plan.
- Sleep apnea: Loud snoring, pauses in breathing, gasping during sleep or excessive daytime fatigue may be signs of sleep apnea.
Frequently asked questions
Can I do a sleep study in my own home?
Yes, in some cases, you can do a sleep study at home. Home sleep testing uses a small device to monitor your breathing, oxygen levels and heart rate while you sleep in your own bed. Before your test, you'll receive instructions on how to set up the machine and properly place the sensors. We'll show you how everything works so you can feel confident using the equipment. Your doctor will let you know if this option is right for you.
What causes sleep apnea?
Sleep apnea occurs when breathing repeatedly becomes shallow or stops during sleep. The most common type, obstructive sleep apnea (OSA), happens when the muscles in the back of the throat relax too much, causing the airway to become partially or completely blocked.
A less common type, central sleep apnea (CSA), occurs when the brain doesn't consistently send the proper signals to the muscles that control breathing.
Several factors can increase the risk of sleep apnea, including excess weight, aging, certain anatomical features of the airway, heart conditions, stroke and the use of some medications, such as opioid pain medications.
Learn how to spot the signs of sleep apnea.
How common is sleep apnea?
Sleep apnea is more common than many people realize. An estimated 26% of adults in the U.S. between the ages of 30 and 70 have obstructive sleep apnea, yet many cases remain undiagnosed. As awareness of sleep apnea grows and risk factors such as obesity increase, more people are being identified and treated for this condition.
What treatments are available for sleep apnea?
Treatment for sleep apnea depends on the type and severity of your condition, as well as your individual needs. The goal of treatment is to keep your airway open during sleep, improve your symptoms and reduce health risks associated with untreated sleep apnea.
The most common treatment is Continuous Positive Airway Pressure (CPAP) therapy, which uses a steady stream of air delivered through a mask to keep your airway open while you sleep. A CPAP machine includes a small air pump, tubing and a mask that may cover your nose, mouth or both. CPAP is often recommended for people with mild, moderate or severe obstructive sleep apnea.
Benefits of CPAP may include:
- Better sleep quality and increased daytime energy
- Reduced snoring
- Improved concentration and alertness
- Lower risk of health problems associated with untreated sleep apnea, including high blood pressure and heart disease
It can take time to adjust to CPAP therapy, but your care team can help you find the right mask, settings and support to make treatment more comfortable.
What if I can’t tolerate CPAP?
For people with moderate to severe obstructive sleep apnea who have not been successful with CPAP, Hypoglossal Nerve Stimulation (HNS) may be an option. HNS is an implantable device that works with your natural breathing pattern to stimulate the muscles that help keep your airway open during sleep.
Other options include:
- Oral appliance therapy: A custom device made by a qualified dental provider that helps reposition the jaw or tongue to keep the airway open. This may be an option for some people with mild obstructive sleep apnea.
- Lifestyle changes: Changes such as weight management, regular exercise and positional therapy may help improve symptoms for some people.
- Surgery: In some cases, procedures may be recommended to help improve airflow by addressing areas that contribute to airway blockage.
What is narcolepsy?
Narcolepsy is a chronic neurological disorder that impairs the brain's ability to regulate sleep-wake cycles. There are 2 types:
- Type 1: During the day, you feel excessive sleepiness and may have sudden muscle tone loss triggered by a strong emotion.
- Type 2: Experience excessive sleepiness but don't experience loss of muscle tone. Taking a nap will leave you feeling refreshed.
How is narcolepsy treated?
There’s no cure for narcolepsy, but treatment can help manage symptoms and make it easier to stay awake, sleep better and take part in daily activities. Because narcolepsy affects everyone differently, your care team will work with you to create a treatment plan based on your symptoms and lifestyle. Treatment may include:
- Medications: Certain medications can help reduce excessive daytime sleepiness and improve alertness. Some treatments may also help manage other symptoms, such as sudden muscle weakness (cataplexy).
- Planned naps: Taking short, scheduled naps during the day can help reduce sleepiness and improve energy levels.
- Healthy sleep habits: Keeping a regular sleep schedule, creating a relaxing bedtime routine and making sleep a priority can help support better rest.
- Lifestyle changes: Regular exercise, staying active and planning your day around your energy levels may help you better manage symptoms.
With the right treatment and ongoing support from a sleep specialist, many people with narcolepsy are able to better manage their symptoms and maintain a full, active life.
How can I improve my sleep overall?
Improving sleep can involve setting a regular sleep schedule, reducing caffeine intake, creating a comfortable sleep environment and managing stress. For more serious issues, treatment options like therapy or medications may be recommended.
Think you might have a sleep disorder? Schedule a consultation with Tufts Medicine's sleep medicine team and get the answers you need to sleep better and live healthier.
