Is a Type 2 Sleep Study Right for You?
What is a type 2 sleep test?
A type 2 sleep test generally refers to an unattended type 2 home sleep study. This is a sleep study that is performed at home and set up by the patient himself or herself. "Unattended" means that there is no one setting up the device on you or monitoring you during the study. There are also attended type 2 home sleep studies which may be performed in a sleep lab or at a patient's home and are setup and monitored by a sleep technologist, but these are rarely performed.
A type 2 sleep study measures EEG (brain waves) as well as respiratory and oxygen data. They differ from attended type 1 sleep studies in that these studies are typically performed in a laboratory and include more sensors applied to your body than are used in a type 2 sleep study. The extra sensors in a type 1 sleep study monitor heart rate and rhythm (EKG), EMG (muscle tone), and EOG (eye movements). The extra leads for EKG, EMG, and EOG are not needed to diagnose sleep apnea, which is the most common reason for undergoing a sleep study.
Do type 2 sleep studies have other names?
Yes, a type 2 home sleep study may also be referred to as a "type ii sleep study," "home sleep study with EEG," or "EEG home sleep study."
What is the difference between a type 2 home sleep study and a type 3 or 4 home sleep study?
The EEG monitoring that is used in a type 2 sleep study allows sleep time to be determined. In theory, this helps to get more accurate results. Type 3 and type 4 sleep studies do not measure sleep time so the AHI, or number of abnormal breathing events per hour, is an estimate based on "time in bed." The assumption is that you are asleep the entire time in bed although this may not be the case. Patients that have significant insomnia may have an inaccurate AHI if they use a type 3 sleep study. This is the main advantage of type 2 sleep studies over type 3 and 4 sleep studies.
Why would someone specifically want a type 2 home sleep apnea test as opposed to a type 3 or 4 home sleep apnea test?
If you are a pilot and being required to have a sleep study by your AME, you will either need to have an in-lab type sleep study or a type 2 sleep study, which can be performed at home. Type 2 sleep studies are usually a lot more convenient and have a faster turn-around-time.
The other common reason that people may prefer a type 2 sleep study is the increased accuracy in determining whether you have sleep apnea or not and, if you do have sleep apnea, its severity. There are more treatment options available to people with mild or moderate obstructive sleep apnea than severe obstructive sleep apnea, which requires a CPAP machine. So getting an accurate determination of your degree of sleep apnea could really be important for some people who are not keen on CPAP.
Is it harder to perform a type 2 home sleep test than a type 3 or 4 home sleep test?
You have to apply the EEG electrodes to your head yourself. With the latest generation of type 2 sleep study devices, such as the Zmachine, it is typically not a problem for most folks. Here's a video that shows you have to setup the Zmachine so you can get a sense of what it would be like. Other than that, the setup protocol is the same as a type 2 sleep study.
Can I rent a home sleep test, type 2?
Yes, although most companies offer type 3 or 4 sleep study equipment to rent, several organizations offer the rental of type 2 sleep study units.
Can I order a type 2 home sleep study myself or do I need a referral to do so?
This is up to the policy of the organization. Some groups require a formal referral be submitted from an appropriately licensed healthcare provider. Singular Sleep allows patients to order type 2 sleep studies themselves.
What does a report from a type 2 home sleep apnea test look like? What information will it show?
Here is an example of a type 2 home sleep apnea study report. Private health information has been redacted.
Can a type 2 sleep study detect RERAs?
In theory, yes. Since type 2 sleep studies accurately assess sleep and wakefulness, they can accurately detect respiratory effort-related arousals (RERAs) which are subtle respiratory events that type 3 and type 4 sleep studies cannot detect.
What is the diagnostic code for a sleep study, type 2?
There are two sets of codes for sleep studies, CPT codes and "G" codes.
The G code for a type 2 home sleep study is G0398 which signifies "home sleep study test (HST) with type II portable monitor; unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort, and oxygen saturation."
The CPT code for a type 2 home sleep study is 95800 defined as, "CPT code 95800 refers to a sleep study, unattended, simultaneous recording: heart rate, oxygen saturation, respiratory analysis (e.g. by airflow or peripheral arterial tone) and sleep time."
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