For most adults with suspected obstructive sleep apnoea, a home sleep study is the right first test. NICE recommends a home respiratory study first, and American guidance agrees for uncomplicated cases. An attended overnight study in a sleep centre is for significant heart, lung or nerve conditions, an inconclusive home result, or a disorder a home test cannot measure.
What does each test measure?
A home respiratory study, also called respiratory polygraphy, records at least four channels, such as blood oxygen, breathing, pauses in breathing, snoring and body position. Polysomnography adds brain activity, eye movement and muscle tone, which show how long and how well you actually slept (NICE NG202).
That difference matters. Without brain wave channels, a home study divides the breathing events by the time it was recording rather than the time you were asleep, and it cannot detect shallow breaths that only cause a brief waking. Both can lead it to underestimate how severe sleep apnoea is (AASM, 2017).
Which test do guidelines recommend?
In the UK, NICE recommends offering home respiratory polygraphy to people with suspected obstructive sleep apnoea. It advises considering polysomnography if the polygraphy result is negative but symptoms continue (NICE NG202).
The American Academy of Sleep Medicine recommends either polysomnography or a home test with a technically adequate device for uncomplicated adults with signs of moderate to severe sleep apnoea. It recommends polysomnography if a single home test is negative, inconclusive or technically inadequate (AASM, 2017).
When is the overnight study the better choice?
American guidance recommends polysomnography rather than a home test for people with significant heart or lung disease, possible breathing muscle weakness from a nerve or muscle condition, low breathing while awake or suspected low breathing in sleep, regular opioid use, a history of stroke, or severe insomnia (AASM, 2017).
The overnight study also looks beyond breathing. European guidance recommends polysomnography when other sleep disorders such as periodic limb movement disorder are suspected, and for insomnia that has not responded to treatment (European Insomnia Guideline, 2023).
What is each test like?
A home study is one night in your own bed. You put on a small recorder with sensors for oxygen and breathing, sleep as usual in your own surroundings, and the recorder is collected afterwards.
An attended overnight study takes place in a sleep centre. A technologist fits sensors on the scalp, face, chest and legs, watches the recording through the night and can refit a sensor that comes loose.
Which should you book?
Most people do not need to decide alone. A doctor's assessment of your symptoms, health and medicines decides which test fits, and it often saves the cost of the wrong one. For signs to look for first, see signs of sleep apnoea in adults, and for prices, what a private sleep study costs in London. Our home sleep study page covers the home test in more detail.
Sleep studies at The Wellness
Our Sleep Clinic starts with a Sleep Consultation at £450, a 60-minute consultation with a doctor, ending with a clear answer on whether you need a sleep study and which one. The Home Sleep Study is £1,395, a one-night respiratory study in your own bed, reported by a consultant in respiratory and sleep medicine, with a results consultation and your wearable data reviewed alongside it. The Attended Overnight Sleep Study is £3,450, a fully attended night in a London sleep centre with brainwave sleep staging, a consultant report and a results consultation. The Sleep Clinic programme, which most people choose, is £2,995 and takes you from the home study to a consultant, blood tests and a plan reviewed at three months.
Choosing the right test first matters, because untreated sleep apnoea carries real risks, from road crashes to heart disease (Tregear, 2009; Marin, 2005). Book a sleep consultation and we will tell you which study, if any, you need.
This article is general information and does not replace a consultation. If you are falling asleep at the wheel, stop driving until you have been assessed. If you have chest pain, severe breathlessness or signs of a stroke, call 999.
Frequently asked questions
Is a home sleep study as accurate as a lab sleep study?
For typical adults with suspected moderate to severe sleep apnoea, guidelines accept either. A home study can underestimate severity, because it measures recording time rather than sleep time and cannot see the brief wakings a lab study records. That is why a negative home study with strong symptoms is followed by a lab study.
Can a home sleep study diagnose insomnia?
No. Insomnia is diagnosed from a clinical interview, questionnaires and a sleep diary. A sleep study is used when another sleep disorder is suspected or insomnia has not responded to treatment.
What happens if my home sleep study is normal but I still feel unwell?
Both NICE and American guidance advise a full overnight study when a home test is negative or inconclusive and symptoms continue.
How long does a home sleep study take?
It takes one night. You wear the recorder in your own bed and it is collected afterwards. At The Wellness the study is reported by a consultant and followed by a results consultation.
Speak to the team about sleep
See what we offer, then book when it suits you.