Guide to Sleep Studies for Seniors

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Older adults are more likely to experience sleep disorders and disturbances than younger people. Experts recommend that adults aged 65 and older should aim for seven to eight hours of sleep per night, and the quality of their sleep is also extremely important.

Studies suggest that restorative sleep improves brain function. Sleep-deprived people have a tougher time learning and thinking. Poor sleep in older adults is also associated with health problems like cardiovascular disease, pain, depression, and a higher risk of falls.

Sleep studies can diagnose many disorders that interfere with sleep quantity and quality. When they identify the cause of sleeping problems, these studies can help put older people on a pathway to healthier sleep.

It can be difficult to find reliable information on sleep studies for older adults, so we focus on accurate, up-to-date research about sleep studies and review practical information for older adults to improve their nightly sleep.

What Can a Sleep Study Diagnose in Seniors?

Sleep studies can often find the underlying cause of poor sleep by detecting many sleep-related disorders, like sleep apnea or periodic limb movement disorder.

These and other conditions frequently affect older adults, making it harder for them to get a sufficient amount of restorative sleep. Sleep studies are crucial in finding the root causes of many sleep disruptions, and diagnosing a sleep disorder can provide a pathway to improving sleep and overall health. Below are examples of some sleeping problems that a sleep study may help identify.

Sleep Apnea

Obstructive sleep apnea is a condition in which breathing pauses during sleep due to a blocked airway at the back of the throat. Excessive daytime sleepiness and loud snoring are common symptoms of sleep apnea.

Older age is a risk factor for developing sleep apnea, which increases the prevalence of this disorder in older adults. Studies indicate that sleep apnea can impair attention, reaction time, and problem-solving, and it has been associated with cognitive decline and dementia. It is also linked to cardiovascular problems like high blood pressure, heart disease, and even strokes.

A sleep study can demonstrate whether a person has disrupted breathing during sleep and determine the severity of sleep apnea. Sleep studies can also help plan treatment for people with sleep apnea.

Insomnia

Insomnia is the inability to fall or remain asleep. Older adults are more likely to experience insomnia, which often occurs alongside other health issues. Several studies have found that poor sleep over time can contribute to numerous health problems, including cognitive decline, depression, and cardiovascular conditions.

Not everyone with insomnia needs a sleep study, but this testing may be helpful for some people to make sure that sleeping problems aren’t caused by another disorder.

Restless Legs Syndrome

Restless legs syndrome causes a powerful urge to move the limbs when inactive or lying down. This condition becomes more common as people get older and can occur in conjunction with other sleep disorders.

A sleep study is not required to diagnose restless leg syndrome, but a sleep study can help evaluate the severity of the condition and rule out other causes of sleep disruptions.

Periodic Limb Movement Disorder

Periodic limb movement disorder involves sleep disruptions from numerous brief and involuntary movements of the arms, hands, legs, or feet. These limb movements are believed to be more common with aging and may occur in over half of people over the age of 65.

Periodic limb movements frequently affect people who have restless leg syndrome and some other sleep disorders. A sleep study can measure the total number and frequency of these movements as well as their effect on sleep.

Narcolepsy

Narcolepsy is a sleep disorder in which individuals experience excessive daytime sleepiness that may cause them to fall asleep suddenly. People with narcolepsy may also have disrupted nighttime sleep, sudden loss of muscle tone while awake, sleep paralysis, and other symptoms.

Although narcolepsy is usually identified earlier in life, in some people the condition may arise at an older age or go unrecognized and undiagnosed for many years. Diagnosis of narcolepsy requires a sleep study.

REM Sleep Behavior Disorder

Individuals with REM sleep behavior disorder physically act out parts of their dreams during the rapid-eye movement stage of sleep. People with this disorder remain asleep and are not aware of their movements, which may be dangerous for themselves or bed partners.

REM sleep behavior disorder is most common in older people and is often linked to other health conditions that more frequently affect older adults, including Parkinson's disease and dementia.

By tracking sleep stages and monitoring physical movements in bed, a sleep study is an essential test to conclusively determine if a person has REM sleep behavior disorder.

Circadian Rhythm Sleep Disorders

Circadian rhythm sleep disorders involve disruptions to the body’s internal clock that helps regulate a person’s sleep schedule. In older adults, this can involve going to bed much earlier and having difficulty sleeping through the night. Circadian rhythm disruptions can contribute to irregular sleep times that interfere with consistent rest.

People with circadian rhythm sleep disorders often do not need a sleep study. However, these disorders can occur at the same time as other conditions, so testing may be used to identify another sleep disorder affecting daily sleep patterns.

What Is a Sleep Study?

In a sleep study, a health professional monitors different functions of the body while you sleep. Several types of sleep studies may be prescribed depending on your symptoms.

Polysomnography

In polysomnography, you sleep under the supervision of a sleep specialist while you are connected to sensors that monitor key sleep-related data, including brain waves, eye movement, body position, and breathing.

This test requires spending at least one night in a specialized sleep clinic. You can prepare for a polysomnography study by getting a regular night's sleep beforehand. The doctor may provide other instructions about avoiding certain substances that can affect sleep.

Polysomnography offers the most in-depth look at how you sleep, which makes it an important tool for the diagnosis of disorders like sleep apnea, narcolepsy, and REM sleep behavior disorder.

CPAP Titration

A CPAP titration sleep study is done in concert with polysomnography to identify the proper treatment for people who have obstructive sleep apnea.

A CPAP machine helps stabilize breathing in people with sleep apnea by providing a continuous stream of air through the nose or mouth. This air is pressurized, which helps keep the airway open and allow the body to get the oxygen it needs.

A CPAP titration study is the way that the doctor can determine the right settings for the CPAP device to work properly. The study involves using a CPAP device during a polysomnography test, which allows the CPAP to be calibrated to suit your needs.

Sometimes a CPAP titration test is done on the same night as an initial polysomnography test to diagnose sleep apnea. Other times, you may have to schedule a second visit to the sleep clinic for CPAP titration.

Multiple Sleep Latency Test

A multiple sleep latency test involves trying to take a daytime nap during five separate two-hour periods. The test is done in a sleep clinic and takes around a full day to perform.

This sleep study uses the same monitoring equipment as overnight polysomnography. A sleep specialist tracks how long it takes to fall asleep and other important data about the nature of this daytime sleep.

A multiple sleep latency test is most often used to diagnose conditions that involve excessive daytime sleepiness. Before this test, it is important to follow the doctor’s instructions, which can help make sure that your sleepiness on the day of the test is comparable to what you normally experience.

Home Sleep Apnea Testing

Some people can be tested for sleep apnea without having to spend the night in a sleep clinic. A home sleep apnea test does not collect as much data as polysomnography, but it can provide information about breathing and oxygen levels.

Using this data, your doctor may be able to determine if you have severe obstructive sleep apnea. However, in many cases, overnight polysomnography in a sleep clinic is needed to confirm the results of an at-home sleep apnea test.

How Much Does a Sleep Study Cost for Seniors?

The cost of a sleep study for older adults varies based on their insurance coverage. Before completing a sleep study, older individuals should confirm that the test provider is in their network to ensure that their insurance will cover the procedure.

After turning 65, most Americans qualify for Medicare Part B, which covers outpatient procedures, including sleep studies if they have symptoms of a sleep disorder.

Medicare Part B pays for 80% of a sleep study, leaving the individual to pay the remaining 20% after meeting their deductible. If you have private insurance in addition to Medicare, your coverage rates and deductible will vary based on your policy, which will affect your total out-of-pocket costs.

Sleep studies can have different components, so it is important to check with your doctor as well as Medicare or your private insurance provider to clarify exactly what charges for the sleep study will be covered.

Prices also vary between tests and providers. Charges can range from several hundred to several thousand dollars depending on the type of sleep study and where it is performed. The amount that you will have to pay will be determined by your insurance coverage.

Does Medicare Cover Sleep Studies?

Medicare covers some but not all sleep studies. Individuals must fulfill certain requirements for coverage. Similarly, Medicare will only cover tests for specific conditions.

Under Medicare, there are four types of sleep studies that may be covered: 

  • Type I: This polysomnography sleep study takes place at a sleep clinic under the guidance of a health professional.
  • Type II: A type II test does not involve monitoring by a health professional and may take place at home. Type II tests track seven different body functions, including oxygen saturation, heart rate, and brain waves.
  • Type III: This is like a type II test except that it monitors four different body functions during sleep.
  • Type IV: In a type IV test, the monitoring device tracks three body functions while you sleep.

Medicare may cover all four types of sleep studies for people who have symptoms of sleep apnea if other criteria are met. They must be ordered by a doctor.

If your doctor suspects you may have another sleep disorder, such as narcolepsy, restless legs syndrome, or a parasomnia like REM sleep behavior disorder, Medicare may cover a type I sleep study. Sleep studies for other conditions, like chronic insomnia, may not be covered.

Medicare coverage decisions are typically related to your symptoms, your doctor’s evaluation of your situation, the type of sleep study recommended, and where and how that test is performed.

Treating Sleep Apnea in Seniors

Available treatments for sleep apnea in older individuals vary based on the severity of the condition and the presence of any other health issues. CPAP therapy is a primary treatment for older adults with sleep apnea. In most people, using a CPAP improves sleep quality and reduces daytime drowsiness.

Older people can also make lifestyle changes to help address sleep apnea. Losing weight, reducing alcohol consumption, avoiding certain medications, and changing sleeping positions may contribute to reduced symptoms of obstructive sleep apnea.

Specific types of oral devices may be prescribed for some patients as another way of improving breathing during sleep. In more extreme cases, surgical procedures may be necessary. However, surgery is used sparingly because of the availability of other effective treatments and the risk of complications.

Frequently Asked Questions About Sleep Studies for Seniors

What Is the Most Common Sleep Disorder in Older Adults?

Sleep apnea is the most common sleep disorder in older adults. Many older people are also affected by chronic insomnia and other sleep disorders. It is possible for people to have more than one type of sleep disorder at the same time.

What if I Can’t Sleep During a Sleep Study?

If you have difficulty sleeping during a sleep study, talk with your doctor or the health professional conducting the test.

Some people have difficulties sleeping during a sleep study because of the anxiety and disruption that can occur from wearing the device sensors, knowing that your sleep is being tracked, and spending the night in an unfamiliar environment. In most cases, testing can proceed even if you have some trouble sleeping.

How Does a Sleep Study Work?

Sleep studies monitor body functions such as heart rate, brain patterns, and air flow while an individual sleeps. There are multiple types of sleep studies.

The most advanced sleep studies take place at sleep centers under the supervision of a health professional. Some types of sleep studies can also be done at home.

Can I Complete a Sleep Study at Home?

Depending on your symptoms, a sleep study may occur at home. At-home tests may be able to detect severe cases of sleep apnea.

However, an at-home test does not offer the same level of information as a test done in a sleep clinic. For this reason, your physician may require follow-up testing in a sleep center after your at-home test.

Can I Bring Personal Items to a Sleep Study?

You can bring usually personal items, such as a pillow, blanket, or comfortable pajamas, to a sleep study. This may help you follow your typical sleep patterns, which can provide more dependable test results. For questions about any specific personal items, contact your doctor or sleep clinic.

Resources for Seniors and Caregivers

  • Science of Sleep Resources: This page from the National Institute on Aging provides links to brochures and sleep diaries for older adults to achieve restful sleep. The National Institute on Aging also collaborates with other government agencies to deliver live Q&A sessions on sleep.
  • Sleep Apnea: The National Heart, Lung, and Blood Institute page on sleep apnea provides information about treatment, causes, and risk factors for this condition.
  • Alzheimers.gov: Older individuals and caregivers looking to learn more about memory problems and dementia can find helpful resources on this page from the National Institutes of Health.
  • HealthinAging.org: This website includes helpful resources for various aspects of health in older adults, including sleep.
  • Aging and Sleep: The World Health Organization’s page on Aging and Health provides statistics and explanations of major medical issues that affect older adults.

References

+ 24 Sources
  1. 1. Accessed on March 22, 2022.https://pubmed.ncbi.nlm.nih.gov/29263993/
  2. 2. Accessed on March 22, 2022.https://pubmed.ncbi.nlm.nih.gov/29073412/
  3. 3. Accessed on March 22, 2022.https://pubmed.ncbi.nlm.nih.gov/24136970/
  4. 4. Accessed on March 22, 2022.https://pubmed.ncbi.nlm.nih.gov/30649500/
  5. 5. Accessed on March 22, 2022.https://medlineplus.gov/ency/article/000811.htm
  6. 6. Accessed on March 22, 2022.https://www.uptodate.com/contents/clinical-presentation-and-diagnosis-of-obstructive-sleep-apnea-in-adults
  7. 7. Accessed on March 22, 2022.https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/sleep-disorders/insomnia-and-excessive-daytime-sleepiness-eds
  8. 8. Accessed on March 22, 2022.https://pubmed.ncbi.nlm.nih.gov/32742587/
  9. 9. Accessed on March 22, 2022.https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-restless-legs-syndrome-and-periodic-limb-movement-disorder-in-adults
  10. 10. Accessed on March 22, 2022.https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-narcolepsy-in-adults
  11. 11. Accessed on March 22, 2022.https://pubmed.ncbi.nlm.nih.gov/20524706/
  12. 12. Accessed on March 22, 2022.https://www.uptodate.com/contents/causes-of-impaired-sleep-including-sleep-apnea-in-older-adults
  13. 13. Accessed on March 22, 2022.https://www.uptodate.com/contents/rapid-eye-movement-sleep-behavior-disorder
  14. 14. Accessed on March 22, 2022.https://www.uptodate.com/contents/overview-of-circadian-sleep-wake-rhythm-disorders
  15. 15. Accessed on March 22, 2022.https://medlineplus.gov/ency/article/003932.htm
  16. 16. Accessed on March 22, 2022.https://www.uptodate.com/contents/titration-of-positive-airway-pressure-therapy-for-adults-with-obstructive-sleep-apnea
  17. 17. Accessed on March 22, 2022.https://www.uptodate.com/contents/approach-to-the-patient-with-excessive-daytime-sleepiness
  18. 18. Accessed on March 22, 2022.https://www.nhlbi.nih.gov/health-topics/sleep-studies
  19. 19. Accessed on March 22, 2022.https://pubmed.ncbi.nlm.nih.gov/30518456/
  20. 20. Accessed on March 22, 2022.https://www.medicare.gov/coverage/sleep-studies
  21. 21. Accessed on March 22, 2022.https://www.medicare.org/articles/medicare-coverage-for-sleeping-disorders/
  22. 22. Accessed on March 22, 2022.https://pubmed.ncbi.nlm.nih.gov/12795623/
  23. 23. Accessed on March 22, 2022.https://pubmed.ncbi.nlm.nih.gov/26022945/
  24. 24. Accessed on March 22, 2022.https://www.uptodate.com/contents/management-of-obstructive-sleep-apnea-in-adults

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