How Is Sleep Apnea Diagnosed? A Simple 3‑Step Guide

Sleep apnea is a chronic health condition where people repeatedly stop breathing during sleep, affecting over 20% of adults in the US, more than 80 million Americans. Sleep apnea keeps people from falling into the deep sleep that the body needs, and puts a strain on long-term health.

According to an NIH study, untreated sleep apnea can lead to increased cardiovascular disease, stroke, metabolic disease, traffic accidents, and in the worst case, death. Yet, 80% of the people living with sleep apnea are undiagnosed.

If you’ve noticed symptoms such as loud snoring or gasping sounds while sleeping, waking up with a dry mouth or headache, or difficulty staying awake during the day, you may have sleep apnea. But how is sleep apnea diagnosed? 

After a doctor evaluates your symptoms and orders testing, sleep apnea is diagnosed through a sleep study that measures your breathing and other vital signs during sleep. Getting diagnosed can feel intimidating, but it can also be life changing. Below, we walk you through the diagnosis process in three simple steps, so you know exactly what to expect.

Step 1: Talk to Your Doctor

If you have identified signs and symptoms of sleep apnea in yourself or a loved one, it’s time to talk to a healthcare professional. Start by talking with your doctor about your symptoms. If possible, bring observations from a partner or roommate since they may notice nighttime symptoms you do not.

Not all doctors are familiar with sleep disorders, so you may need to advocate for yourself to receive a referral to a board-certified sleep specialist who can properly evaluate your symptoms.

Check out our resource, Talking to your Doctor about Sleep Issues, for effective language to describe symptoms and tips to get a referral to a sleep specialist. Once you have approval from a doctor, it’s time to get tested. 

Remember that you are the expert of your situation and the PCP might not necessarily be a sleep expert. It might not be you asking your PCP what to do, but instead suggesting that maybe you could have a sleep disorder and that you’d like to be evaluated by a sleep specialist.”

– Julie Flygare, President & CEO, Project Sleep

Step 2: Get Tested for Sleep Apnea

Sleep apnea is assessed with a sleep study that uses stick-on sensors to measure breathing, heart rate, brain activity, and body movements while asleep. There are two ways to get tested: 

• An in-lab study (polysomnography) conducted overnight at a hospital or sleep clinic
• A home sleep apnea test (HSAT) completed in your own bed

In-lab studies are the most comprehensive and can detect a wide range of sleep disorders. Home testing collects less information but may be more convenient for straightforward cases. Your doctor will help determine which option is appropriate based on your symptoms, medical history, and insurance coverage. Learn more about this process in our resource, Sleep Apnea Testing.

Step 3: Understand Your Results and Receive a Diagnosis

To obtain a sleep apnea diagnosis, the test must show five or more “events” per hour. As defined by the American Academy of Sleep Medicine (AASM), these events include: 

• Apneas, which are complete pauses in breathing for at least 10 seconds
• Hypopneas, which are partial airway blockages accompanied by a 3% drop in oxygen

These events reduce airflow and oxygen levels, triggering the brain to wake the body repeatedly, thus keeping people from falling into the deep sleep that the body needs. 

After your diagnosis, your sleep specialist will explain your results, discuss your apnea severity, and help you choose a treatment plan that fits your needs. CPAP is commonly prescribed as a first-line treatment, but it is not the only option. People often try multiple treatments or combinations to find what works best. Options include:

• PAP Therapy
• Oral Appliance Therapy
• Positional Therapy
• Medications
• Hypoglossal Nerve Simulator Implant
• Ear, Nose, and Throat Surgeries
• Oral & Maxillofacial Surgery

To learn more about the various sleep apnea treatment options, see our resource, Sleep Apnea Treatment Options.

What works for me might not work for you. That doesn’t mean either treatment is more important. It’s not a cookie cutter thing, it’s a ‘choose your own adventure.’”

– Karen Wolk, person living with sleep apnea

Navigating a Negative Sleep Apnea Test Result

A negative sleep apnea test does not completely rule out sleep apnea as the cause of symptoms. Night-to-night variability, positional apnea, or limitations of home testing can all affect results. Other sleep disorders may also interfere with accurate readings. If you’ve received a negative sleep apnea test result, learn more about your options in Sleep Apnea Testing. 

In addition, not all insurance organizations follow AASM’s updated diagnostic guidelines. For example, insurance through the Centers for Medicare & Medicaid Services (CMS) uses older criteria that may affect whether a diagnosis is recognized. See more about this issue and what Project Sleep is doing to modernize sleep apnea coverage at CMS.

Frequently Asked Questions About Sleep Apnea Diagnosis

Can sleep apnea be diagnosed without a sleep study?
While diagnosing sleep apnea typically involves a combination of clinical evaluation and symptom assessment, a sleep study is required to confirm the presence and severity of the condition.

How can I take a sleep apnea test at home?
There are two main ways to access home sleep apnea tests. Firstly, your physician can arrange for you to pick up testing equipment, and technicians will demonstrate how to set it up at home. Alternatively, you could access a home test through an online telehealth company. In this scenario, your appointment with a doctor is conducted online, and the sleep apnea test is delivered directly to your home.

Which companies offer home sleep apnea testing kits?
The companies listed below offer at-home telemedicine appointments and at-home sleep apnea testing. Out-of-pocket expenses and insurance coverage vary between providers.

*Project Sleep does not recommend or endorse any of these companies or products. They are listed for educational purposes only; Project Sleep does not provide medical advice. Please consult a healthcare provider.

What if my sleep study is negative or inconclusive?
A negative or inconclusive sleep study does not necessarily mean you do not have sleep apnea. Home sleep apnea tests are less comprehensive and more prone to inaccuracies, so a negative result often requires follow-up with an in-lab polysomnogram. Night-to-night variability can also affect results, meaning a single test may not reflect your typical sleep. If symptoms persist, advocate for additional testing. If your provider is unsure how to proceed, Project Sleep’s Sleep Helpline can help you find qualified sleep centers and support your next steps.

Get Help at Any Point with Project Sleep’s Sleep Helpline

Getting tested and navigating the healthcare system can feel overwhelming, but you do not have to figure it out alone. Whether you are just starting to explore symptoms, preparing for a sleep study, or trying to understand confusing results, Project Sleep’s Sleep Helpline is here to support you at every step.

The Sleep Helpline is a free, national resource offering personalized support and trusted information for people facing sleep issues and sleep disorders. Reach out to connect with a compassionate Resource Specialist who will listen and help provide accurate sleep disorder information, resources to help you navigate daily living and the healthcare landscape, and connect you to certified sleep centers and patient support organizations.

Sleep Helpline Resource Specialists are available Monday to Friday 9 a.m. – 4 p.m. (Eastern Time). Leave us a message 24/7 and we’ll get back to you on the next business day.

Call us: 1-800-819-2043
Email us: helpline@project-sleep.com
Learn more: project-sleep.com/helpline

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