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Need-to-know facts about sleep apnea and sleep studies

Home-based vs. facility-based sleep studies

This article was last updated on Oct. 2, 2020. 

Are your sleep issues keeping you up at night? Don't rule out sleep apnea. It's a common condition in the United States, yet 80 percent of those who have it don't know they do. The only way to diagnose sleep apnea is through a sleep study External Site, which may require an overnight stay in a facility. But, you may be able to use an at-home sleep study option, too.

Here, you can learn the facts about these tests, plus how much a sleep test might cost you. 

What is sleep apnea?

Affecting an estimated 22 million Americans, sleep apnea External Site can occur when your upper airway repeatedly becomes blocked while you’re sleeping, which reduces or stops your breathing altogether. Your body wakes you up to keep breathing, which may result in a poor night’s sleep. But, sleep apnea does more than make you extra tired during the day. According to the National Heart, Lung and Blood Institute, it can lead to memory loss, asthma, high blood pressure, and a weakened immune system. It also puts pressure on your heart, putting you at greater risk for irregular heart rhythm, stroke and heart failure.

How is sleep apnea diagnosed?

A common symptom of sleep apnea External Site is loud or excessive snoring, but snoring by itself isn't a reason to call your doctor. If you or your partner notice any pauses in breathing, shortness of breath or sudden wake-ups accompanied by choking, it's time to get checked.

During your visit, your physician may ask you questions to rule out other sleep disorders first. To diagnose sleep apnea, your physician will likely recommend a sleep study.

How does a sleep study work and how much will it cost? 

Sleep studies measure several different things, like your breathing rate, blood oxygen level and heart rate. Plus, sleep studies can be done in both a facility setting or at home. While both settings provide a complete evaluation of your sleep, studies done at home allow you to sleep comfortably in your own bed.

The biggest difference between the two is total cost. A home-based sleep study costs a few hundred dollars, while a facility-based sleep study can cost thousands. Your provider (or provider's office) will have to get prior approval from Wellmark for facility-based sleep studies. Prior approval is not required for home-based sleep studies. This ensures you get the more cost-effective option for care, which helps you maximize your health benefits.

If you're a Wellmark Blue Cross and Blue Shield member, you can find out how much a sleep study will cost you by logging in to myWellmark® to check your benefits Opens New Window.

Should I do a sleep study at home or in a facility?

Home-based sleep studies aren't for everyone. If you have certain medical conditions that might alter the accuracy of an at-home sleep study, a facility-based study may be considered medically necessary.

You may also need an facility-based sleep study if your physician suspects you have a sleep disorder other than sleep apnea. Whether or not a facility-based sleep study is medically necessary is determined during prior approval.

If you want to get a better night's sleep, and suspect you may have sleep apnea or another sleep disorder, talk to your personal doctor.