What is the percentage of home sleep studies (Polysomnography (PSG)) done in the United States of America (USA) compared to in-laboratory sleep studies, and what is the ratio of home versus in-laboratory sleep studies?

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Last updated: February 23, 2025View editorial policy

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From the Research

The majority of sleep studies in the USA are now conducted at home, with approximately 60-70% of sleep studies being home-based and 30-40% performed in laboratories, translating to a ratio of roughly 2:1 for home versus in-laboratory sleep studies. Home sleep studies have become increasingly prevalent due to several factors:

  • Cost-effectiveness: Home studies are generally less expensive than laboratory studies, as shown in a study comparing laboratory versus portable sleep studies, which found that home studies ranged from 35% to 88% lower in cost than laboratory studies 1.
  • Convenience: Patients can sleep in their own beds, which may provide more accurate results, as a study on home sleep apnea testing found that results from home sleep monitoring correlate well with the laboratory "gold standard" and may be an option for diagnosing OSAS in selected patients 2.
  • Accessibility: Home studies can be conducted in areas without nearby sleep laboratories, making them a viable option for patients with limited access to sleep centers.
  • Technological advancements: Improved portable monitoring devices have made home studies more reliable, as demonstrated by a study comparing home sleep apnea testing versus laboratory polysomnography, which found that home sleep testing may alleviate issues of access to care and higher costs of laboratory polysomnography 3. However, in-laboratory studies are still necessary for complex cases or when more detailed monitoring is required, as they provide a controlled environment and allow for direct observation by sleep technicians, as noted in a multisite randomized trial of portable sleep studies and positive airway pressure autotitration versus laboratory-based polysomnography for the diagnosis and treatment of obstructive sleep apnea 4. To implement a home sleep study, patients typically receive a portable monitoring device to wear overnight, and they'll need to follow instructions carefully for proper setup and return the device for data analysis, as described in a study on home sleep apnea testing 2. Results are then interpreted by a sleep specialist to determine if further testing or treatment is needed, and while home studies are suitable for many patients, those with certain medical conditions or suspected complex sleep disorders may still require in-laboratory polysomnography for accurate diagnosis and treatment planning, as noted in several studies 1, 3, 4.

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