Does a sleep study in a clinic make sense, and when should you have one?
A clinical sleep study is certainly worthwhile when a home test is not feasible or not sufficient, or when your health situation is more complex. For healthy individuals with a clear suspicion of sleep apnoea, a home test is an adequate first step.
A sleep study in a clinic, where you spend a night connected to monitoring equipment while brain waves, breathing, oxygen levels and muscle movements are recorded, is the most accurate method for detecting sleep disorders. It is considered the gold standard for diagnosing sleep-related breathing disorders such as sleep apnoea. Diagnosing sleep apnoea on the basis of questionnaires or a risk calculation alone is explicitly discouraged by sleep medicine specialists: you always need an objective measurement.
For most healthy adults who are likely to have moderate to severe sleep apnoea, a home test is nowadays a good alternative. Such a home test is less burdensome and less expensive. But if that test comes back negative, is inconclusive, or was not technically successful, a clinic study will still follow. And for people with severe heart or lung disease, muscle weakness, chronic use of opioid-based painkillers, suspected sleep-related hypoventilation (breathing too slowly during sleep), a previous stroke, or severe insomnia, the clinic test is immediately the appropriate choice, because a home test provides too little information in those situations.
For ordinary insomnia, a clinic study is not routinely necessary. It is recommended, however, when the doctor suspects that something else, such as restless legs or sleep apnoea, is causing the insomnia, or when the insomnia does not respond to treatment. For children with extreme daytime sleepiness or narcolepsy, a clinic study is particularly useful, as it is for children who sleepwalk or have other nocturnal behavioural disorders in which sleep apnoea may be lurking.
An interesting area of application is the sleep study conducted during a hospital admission itself. In admitted patients with heart or lung problems, such a test yields a clinically relevant diagnosis in the majority of cases, after which treatment can be initiated. The evidence for this is preliminary, but the direction is clear: sleep apnoea is systematically missed in this group as long as no test is performed.
One point to be aware of: women sleep on their backs more often at home than in a clinic. This can cause the severity of sleep apnoea to be underestimated in a clinic study for this group. If you have doubts about a result, discuss this with your doctor.
This answer is based on guidelines from the American Academy of Sleep Medicine, a European guideline on insomnia, a systematic review on sleep disorders in children, and several other reviews and studies. The evidence for the diagnostic value of the clinic study in sleep apnoea is robust. The findings on sleep studies during hospital admission and on the AI-driven home test are based on smaller studies and are preliminary.
Are sleep trackers accurate enough to help you improve your sleep?
A good wearable shows patterns over time. It overestimates your sleep duration as a rule, and it does not measure your sleep stages reliably. That is enough for following trends; with serious sleep problems, see a doctor.
How much sleep do I really need?
Seven to eight hours per night is the best-supported target range for adults. If you are consistently sleeping fewer than 7 hours, getting more sleep is not a luxury but a serious investment in your health.
Can sleep deprivation raise your blood pressure?
Yes, sleep deprivation demonstrably raises blood pressure in adults. Seven to eight hours of sleep per night is the most well-supported guideline; if you structurally sleep less than that, it is a reason to have your blood pressure checked.
Does pain make me sleep worse, and what can you do about it?
Pain and poor sleep reinforce each other, with sleep deprivation typically aggravating pain more than the other way around. The treatment with the strongest evidence is cognitive behavioural therapy for insomnia (CBT-i), which demonstrably improves sleep, although the pain does not automatically disappear as a result.
Does my sleep change as I get older, and is that normal?
Sleep changes in predictable ways as you age, and much of that is normal. Take notice if your sleep deteriorates significantly, because that is not an inevitable fate and it can have consequences for your memory and health.
Does getting more sleep improve my memory?
Sufficient sleep demonstrably benefits your memory: your brain processes and stores new information while you sleep. Too little sleep impairs that processing after just one night.