Testing

Home Sleep Testing

For Patients

The ResMed sleep diagnostic device that we send to your home is an easy-to-use device. For your convenience, we will pre-assemble the connections required for the test so that all you have to do is follow the enclosed directions for placing the air flow tube under your nose, buckle the belt, secure the sensor around your finger and turn on the device. Goodnight! It's as simple as that.
The device will alert you if it is ready to acquire the appropriate data or not when you turn it on. We'll send you an instructional video along with the device. In addition to the customer service we provide and ResMed provides for the device, we understand that you may feel anxious or nervous about the study. For that reason (and for accuracy) we often acquire data from more than one night. Rest assured, literally.

Home Sleep Testing

For Physicians

Currently, obstructive sleep apnea (OSA) testing in the comfort of the patient's home is the preferred method of sleep apnea confirmation for a large segment of the population. Peer-reviewed studies have consistently verified that home diagnostic testing in tandem with a high pretest probability of OSA (using simple but effective OSA screening methodologies performed in the physician's office) yield a high probability for a correct diagnosis of OSA with Type III portable monitoring devices (i.e., home testing equipment). Clinical guidelines and insurance cost analyses agree on the fact that for much of the population of OSA candidates, home sleep testing is now actually the preferred methodology. See 'Why Test Sleep' below.

There are, of course, limitations to home sleep testing. For example, patients that have coexisting conditions such as congestive heart failure (CHF), advanced pulmonary conditions, neuromuscular conditions, and other select conditions (or a different class of suspected sleep disorder) should be tested in a fully attended laboratory facility following established clinical protocols designed to evaluate multiple channels, including EEG signals that correlate with physiological brain states.

The current payor environment places sleep management responsibility on the referring primary care physician even while the American Academy of Sleep Medicine (AASM) Clinical Guidelines recommended that a sleep specialist oversee the sleep diagnostic process.
With Evo Diagnostics, you don't have to fret about clinical criteria that should be handled by a specialist. Our specialists evaluate incoming referrals and work with your office to select the appropriate candidates for home sleep testing. Many commercial home sleep test providers don't alert you if patients warrant a traditional in-facility sleep study. On the other hand, many sleep labs that are overseen by a sleep specialist still seek to gain authorization for an in-lab study for candidates that should be shunted through the HSAT pathway immediately.

We periodically evaluate the current landscape of clinical sleep diagnostic devices to assess for consistency, ease-of-use, cost-effectiveness, robustness and viability of the device's software to mediate the high demands that we place between our dual-sided emphasis upon accuracy and customer service. In short, only the highest integrity devices pass muster. Currently we utilize ResMed's ApneaLink Air as our principle diagnostic work horse.

ResMed has a longstanding and worthy reputation as the leader in both sleep diagnostics and sleep therapy equipment. By virtue of our own concern with integrating home sleep diagnostics into the larger positive outcome metric of compliance, we find ResMed's positioning as both a diagnostic and treatment leader to be attractive. Our own mission seeks to launch the OSA positive patients that we diagnose onto a path that leads to a successful and fully compliant treatment outcome.

The Diagnostic Process

01

Test Is Ordered By Your Physician

After we receive the order from your doctor, we contact your insurance company and authorize the test for you and your doctor.

02

Convenient Scheduling

We contact you and schedule the test at your convenience. Depending on your insurance, we test 1-3 consecutive nights.

03

Home Sleep Test Administered

Following the easy set-up guide or instructional video, you conduct the test at home and ship us the device at no cost.

04

Data Reviewed by Specialist

Our Sleep Specialist reviews your test and sends a report to your physician with a diagnosis and recommendation.

35%

Of All Hypertensives

At least 35% of all individuals with high-blood pressure have OSA (Sjostrom et al, Thorax).

50%

Of Type II Diabetes

At least 50% of Diabetics have OSA (Einhorn et al, Endocrine Practice); IDF: "Test all Type II Diabetics for OSA".

80%

Drug-Resistant Hypertensives

80% of treatment-resistant hypertensives have OSA (Logan et al, J. Hypertension). Drug-resistant HBP is rising.

>80%

OSA Still Untreated

The prevalence of the adult U.S. population that has undiagnosed OSA is at least 80% (AASM, 2016; T. Young, SLEEP).

Why Test Sleep?

It is increasingly recognized that OSA sets off mechanisms that contribute-to, exacerbate, or sometimes independently cause common cardiovascular and metabolic disorders such as hypertension, arrhythmias, heart failure, insulin resistance, diabetes and obesity. As indicated, there still exists a residual clinical inertia that reflexively interprets sleep disorders to be merely secondary conditions relative to the primary conditions cited above. Based on the emerging data that demonstrate the importance of treating OSA and other sleep disorders independently from conditions once deemed primary, many researchers and clinical associations now advocate that ALL members of certain clinical populations— for example, those with type 2 diabetes, treatment-resistent hypertension, morbid obesity and others— undergo a sleep study.

This may at first sound like an overreach, but the emerging evidence suggests that it is not. There are, in fact, very good clinical and economical arguments for referring all of these patients (type 2 diabetics; drug-resistant hypertensives) for a diagnostic sleep study.
The argument is that although OSA screening questionnaires have been clinically validated to provide an adequate threshold of both selectivity and sensitivity, thus ensuring that most, and only those candidates that are potentially positive are screened positive and selected to undergo OSA diagnostic confirmation through testing, those screening questionnaires are designed for the population at-large and NOT the specific patient populations with those clinical disorders. It is precisely those patients that have the highest likelihood of not only having OSA, but being severely impacted from it. They are also prone to adapting to their conditions and not recognizing (or self-reporting) issues that will invoke OSA screening questionnaires to consider them moderate or severe. Based on this emerging story, it is, in fact, prudent to send all of these patients for a sleep study. Physicians should not only look for traditional signs such as self-reported sleepiness, snoring, witnessed apneas, etc; they should immediately act on objective diagnoses that warrant a sleep study, such as type 2 diabetes and hypertension requiring two or more meds. It is easy to recognize how most estimates project that at least 80% of OSA candidates still remain undiagnosed and blind to the dangers of sleep-disordered breathing.

What Happens If I am Positive for OSA?

Treat OSA

Customer Service

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