Sleep apnea other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.


Other tests for sleep apnea include EEG, EMG, EOG, ECG, a nasal airflow sensor, and a snore microphone.

Sleep Apnea Other Diagnostic Tests

A clinical practice guideline by the American College of Physicians[1] and the American Academy of Sleep Medicine[2][3] address diagnosis.

Other tests

  • EEG (electroencephalogram) to measure and record brain wave activity
  • EMG (electromyogram) to record muscle activity to determine REM stage sleep
  • EOG (electro-oculogram) to record eye movements to determine REM stage sleep
  • ECG (electrocardiogram) to record heart rate and rhythm.
  • Nasal airflow sensor to record airflow
  • Snore microphone to record snoring activity

Home respiratory polygraphy

Home respiratory polygraphy (HRP) or called home sleep apnea testing (HSAT), can be classified into:

  • Level 2 (L2), which include airflow, EEG, EOG, EMG, ECG/HR, effort SaO2
  • Level 3 (L3), which include airflow, thoracoabdominal bands, body position, electrocardiography, and oxygen saturation
  • Level 4 (L4), which added oxygen saturation and maybe heart rate

Randomized controlled trials have compared the impact of using versus portable monitors that can be used at home:

  • Corral found no significant difference.[4].
  • Chai-Coetzer found no difference using L3 channels but inconclusive results with L4 monitoring (which just included oximetry and heart rate)[5].
  • Whitelaw found no significant difference.[6]


  1. Qaseem A, Dallas P, Owens DK, Starkey M, Holty JE, Shekelle P; et al. (2014). "Diagnosis of obstructive sleep apnea in adults: a clinical practice guideline from theAmerican College of Physicians". Ann Intern Med. 161 (3): 210–20. doi:10.7326/M12-3187. PMID 25089864.
  2. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K; et al. (2017). "Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline". J Clin Sleep Med. 13 (3): 479–504. doi:10.5664/jcsm.6506. PMC 5337595. PMID 28162150.
  3. Mokhlesi B, Cifu AS (2017). "Diagnostic Testing for Obstructive Sleep Apnea in Adults". JAMA. 318 (20): 2035–2036. doi:10.1001/jama.2017.16722. PMID 29183053.
  4. Corral J, Sánchez-Quiroga MÁ, Carmona-Bernal C, Sánchez-Armengol Á, de la Torre AS, Durán-Cantolla J; et al. (2017). "Conventional Polysomnography Is Not Necessary for the Management of Most Patients with Suspected Obstructive Sleep Apnea. Noninferiority, Randomized Controlled Trial". Am J Respir Crit Care Med. 196 (9): 1181–1190. doi:10.1164/rccm.201612-2497OC. PMID 28636405.
  5. Chai-Coetzer CL, Antic NA, Hamilton GS, McArdle N, Wong K, Yee BJ; et al. (2017). "Physician Decision Making and Clinical Outcomes With Laboratory Polysomnography or Limited-Channel Sleep Studies for Obstructive Sleep Apnea: A Randomized Trial". Ann Intern Med. 166 (5): 332–340. doi:10.7326/M16-1301. PMID 28114683.
  6. Whitelaw WA, Brant RF, Flemons WW (2005). "Clinical usefulness of home oximetry compared with polysomnography for assessment of sleep apnea". Am J Respir Crit Care Med. 171 (2): 188–93. doi:10.1164/rccm.200310-1360OC. PMID 15486338. Review in: ACP J Club. 2005 Jul-Aug;143(1):21

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