If a primary care doctor has suggested a sleep study, the next question is almost always the same: does the testing happen at home or in a lab? AAIRS Clinic & Troy Sleep Center performs both, and the right answer depends less on patient preference than on what the workup is actually trying to rule in or out.
Home sleep apnea tests and in-lab polysomnography are not interchangeable tools. They measure different things, they're indicated for different patients, and they answer different clinical questions. AAIRS Clinic uses both routinely — sometimes one after the other for the same patient — and which one comes first is a decision the team makes based on the symptoms, the medical history, and what a positive or negative result would actually change. This guide walks through how that decision gets made and what each kind of study involves in practice.
What home sleep testing actually measures
A home sleep apnea test (HSAT) is a simplified, portable recording of breathing and oxygenation during sleep. The standard device worn at home records airflow through a nasal cannula, respiratory effort through a chest or abdominal belt, and oxygen saturation through a fingertip pulse oximeter. Some devices also record body position and heart rate. What a home test does not record, in most cases, is sleep itself — there is no EEG, so the recording cannot distinguish wake from sleep stages.
That distinction matters. Because the device records total recording time rather than total sleep time, mild and even moderate sleep apnea can be under-detected if the patient lay awake for part of the night. The trade-off is significant convenience: the patient sleeps in their own bed, sets up the device themselves with a short instructional video or a brief visit to the office, and returns the unit the next day. For adult patients with a high pre-test probability of moderate-to-severe obstructive sleep apnea — loud snoring, witnessed pauses, daytime sleepiness, a BMI in the right range — the home test is sensitive enough to make the diagnosis without ever needing a lab night.
When an in-lab study is the right first step
In-lab polysomnography at AAIRS Clinic captures a much wider set of signals: EEG (so the recording shows actual sleep stages), EOG, chin and leg EMG, ECG, airflow, respiratory effort, oximetry, snoring, and body position. A trained technologist is present throughout the night to fix electrode issues, swap masks, and respond if the patient meets criteria for a split-night CPAP titration. The result is a recording that captures essentially everything a sleep medicine physician would want to know.
In-lab studies are the appropriate first step in several specific situations: when the suspected diagnosis is something other than straightforward obstructive sleep apnea (central apnea, REM behavior disorder, periodic limb movement disorder, narcolepsy), when the patient has significant cardiopulmonary disease that raises the risk of a missed diagnosis being clinically important, when the patient has a neuromuscular disease or has had a stroke, when prior home tests have come back ambiguous, and for essentially all pediatric sleep evaluation — children rarely tolerate the home setup, and the diagnostic criteria for pediatric sleep-disordered breathing assume a polysomnogram. The pediatric sleep evaluation workup is covered separately for parents trying to understand whether a child needs a study.
How AAIRS Clinic decides for each patient
The intake conversation at AAIRS Clinic & Troy Sleep Center covers the symptom history, comorbidities, prior workups, and the patient's own pattern. From that conversation, the team usually knows within a few minutes whether a home test is the right starting point or whether the situation calls for an in-lab study from the outset. When a home test is appropriate, the device can either be picked up at the practice or shipped to the patient's home, and the recording is interpreted in-house by the same board-certified sleep medicine physicians who read the lab studies.
When a home test comes back positive for moderate-to-severe sleep apnea, treatment can usually begin without a confirmatory in-lab study. When a home test comes back negative but symptoms persist, the next step is typically an in-lab study — because a negative HSAT in a patient who clearly has sleep-disordered breathing means the home recording missed something, not that the patient is fine. This second-pass pattern is common enough that the team plans for it from the first visit, and patients are not asked to start the workup over from scratch.
Treatment after the study
Once a diagnosis is in hand, the next set of choices opens up: continuous positive airway pressure (CPAP), oral appliance therapy in coordination with a sleep dentist, positional therapy for milder position-dependent cases, and — for patients who haven't tolerated CPAP — upper-airway stimulation through Inspire therapy. AAIRS Clinic is recognized as an Inspire Center of Excellence, and the practice has written separately about how Inspire therapy and other CPAP alternatives fit into modern treatment for patients who need a path forward beyond standard mask-based therapy.
Behind any of those treatment choices is a coordinated workup that doesn't stop at the lung — sinus disease, allergic rhinitis, reflux, and asthma all influence sleep-disordered breathing in ways that show up routinely in the clinic. The fact that AAIRS Clinic also handles allergy and pulmonary care under the same roof means the treatment plan can address the upstream contributors rather than treating sleep apnea as an isolated diagnosis. A fuller picture of how the practice coordinates care across specialties is available on the about page, and the team's listing on the main AAIRS Clinic website covers the broader practice profile.
Conclusion
Home sleep testing and in-lab polysomnography both have a place in adult sleep medicine, and the choice between them is a clinical one — not a matter of convenience. AAIRS Clinic & Troy Sleep Center uses both, with the same physicians interpreting both, and the decision about which to start with is made in the first visit based on what the workup needs to answer. Patients in Troy, Sterling Heights, and across Macomb and Oakland counties can reach out to the AAIRS Clinic team to schedule an evaluation or to ask whether their situation is better suited to a home test or a lab night.