Home sleep apnea testing is a safe alternative to the traditional in-lab sleep study performed at a sleep center or hospital sleep lab. “What if I can’t fall asleep during my sleep study?” is the most common concern patients have about sleep testing at-home or in-lab. Here’s how to overcome Insomnia and anxiety (without pills or sedative sleep aides) and avoid the two sleep study mistakes that can prevent you from falling asleep during your sleep study, potentially saving you money in repeat sleep test fees that are often not covered by your health insurance.
Mistake #1: Only One, Single Night Home Sleep Study
The purpose of home sleep testing is to diagnose and identify the type and severity of any breathing-related sleep disorder (like sleep apnea). Sleep apnea is a condition where a person pauses or stops breathing during sleep and is characterized by loud, disruptive snoring or gasping or choking episodes during sleep that result in daytime sleepiness and fatigue. Sleep apnea occurs most notably during deeper stages of sleep (like REM sleep) and can be exacerbated by sleep in the supine position (or sleeping on your back).
The problem with one night (or single night) home sleep testing is that difficulty falling and staying asleep is a well-documented consequence of sleep testing known as the ‘first-night effect,’ an autonomic response to the abrupt change in sleeping conditions. Whenever you make a change to your sleep environment and routine, your brain registers the disruption of sleep patterns and maintains a heightened state of alertness, resulting in lighter and poorer sleep and more awakenings.
As far back as 1966, scientists proved how the first-night effect of sleep testing “decreased total sleep time, lower sleep efficiencies, reduction in REM sleep, and longer REM latencies on the first night of testing.” (Agnew et al. 1966)
Intuitively, all adults understand how the first-night effect works, whether they are traveling out-of-town and sleeping in a hotel, sharing the bedroom with a spouse or partner for the first time, or even when buying a new bed and mattress for the home. Each of these sleep environment changes result in reduced, poorer sleep for the first night (and often for the next 2-3 nights thereafter, until the brain acclimates to the changes).
Home sleep apnea testing patients experience first-night effect symptoms in several ways:
Home sleep apnea study patients take longer to fall asleep on the first night of testing (due to the foreign discomfort with the home testing sensors).
Home sleep testing patients awake more frequently during the first night of testing (to check that the home study sensors have not come off while asleep).
Home sleep study patients are less likely to move into their normal, natural sleep positions out of anxiety of dislodging or damaging the testing equipment (resulting in sleep that may not be representative or accurate).
Mistake #2: Two Night, Non-Contiguous Home Sleep Study
A common home sleep apnea testing protocol is to test a patient for one, single night, and if the testing is ruled inconclusive due to the first-night effect, then the patient is rescheduled for a second, single night home sleep study. However, in this scenario, the second, single night of sleep testing is often conducted days or even weeks after the first night of testing, and in some other cases, uses a different home sleep testing device or sensor placement. The use of two separate, non-contiguous nights of home sleep apnea testing often result in the same first-night effect failures as the one, single night of testing (again, due to the brain’s adaptation process).
Solution: Contiguous, Multi-Night Home Sleep Testing
An effective solution to overcome first-night effect sleep study failures (and the high costs of repeat sleep testing that are often not covered by your health insurance) is to talk to your doctor about contiguous, multi-night home sleep study. A multi-night, contiguous sleep apnea evaluation provides several benefits to overcome the stress and anxiety of sleep testing problems:
The first night of testing will be the poorest and least-representative of your normal sleep. But it will give you the opportunity to get comfortable with the testing device and sensors in a stress-free environment because you know that it is okay when you sleep poorly or dislodge a sensor.
On the second night of testing, you will feel more tired due to the poor sleep from the first night. This will help you to fall asleep sooner. However, there can still remain residual discomforts with the sleep study sensors, and so the second night of contiguous testing can be an improvement over the first night but may still be a poor night of sleep compared to your normal sleep.
On the third and final night of testing, you will have had two nights of testing with the sensors and be most adapted to the study device. The third night of contiguous sleep testing is often the most representative of a normal night of sleep and more likely to give the best sleep apnea readings for your doctor.
Additional Helpful Sleep Resources to Naturally Cure Insomnia:
Do you have sleep problems and need an evaluation sleep study? For home sleep testing and sleep study procedures, consider SleepSomatics, an American Academy of Sleep Medicine accredited sleep disorders center serving Austin, TX for over twenty years. Request an appointment at SleepSomatics for a sleep study now for more information.
References:
Agnew HW Jr, Webb WB, Williams RL. The first night effect: an EEG study of sleep. Psychophysiology. 1966 Jan;2(3):263-6. doi: 10.1111/j.1469-8986.1966.tb02650.x. PMID: 5903579.
