What’s the Cost of a Sleep Study (Polysomnography)?

According to the Centers for Disease Control and Prevention (CDC), an adult needs 7 or more hours of sleep per night.

Roughly 35% of adults get less than the recommended sleep, leading to about 70 million Americans who suffer from chronic sleep problems. Some common sleep disorders include insomnia, sleep apnea, restless leg syndrome (RLS), and narcolepsy. They can result in mental illness, chronic diseases, and injuries.

Below, we’ll look at how sleep studies can diagnose problems that may disrupt your sleep patterns or health. We’ll also look at the types of treatments, costs, and insurance coverage.

What is a sleep study (polysomnography)?

Polysomnography is another word for sleep study. It tracks body functions while you are asleep or attempting to sleep. The equipment — which is called a continuous positive airway pressure (CPAP) machine — measures the following:

• Airflow

• Body position

• Brain waves

• Eye movement

• Heart rate

• Oxygen in your blood

• Snoring

You can have a polysomnography at a sleep center or a department at a hospital. You will typically do this at night or during the time you usually sleep. A healthcare professional will attach electrodes on your eyelids, chin, and scalp. They will also place systems on your chest.

There are at-home devices for sleep studies. These are generally to diagnose obstructive sleep apnea (OSA). This is when you have pauses in your breathing while you are asleep.

How much does a sleep study cost?

According to one source, the national average for a sleep study is $3,075. This is for a procedure at a hospital or sleep center.

New Choice Health also keeps track of data on sleep studies. Their analysis shows that the national average is $2,925, and the range is from $1,250 to $6,700.

Here are the factors that impact the cost of a sleep study:

• Prevailing fees for sleep specialists in the local community

• Sophistication of the sleep-study devices and systems

• Time of day

• Time span of the sleep study — say, for 1 or 2 nights

• Types of tests performed

Are sleep studies covered by insurance?

It depends. Medicare Part B covers medically necessary services, such as doctors’ visits, medical supplies, and preventative services. There is also coverage for sleep studies. However, a doctor must prescribe the treatment for signs of sleep apnea.

Medicare Part B provides coverage for the following sleep studies:

Before you take a test, you want to make sure your doctor accepts Medicare. If not, you will have to pay the full costs for the sleep study.

For Medicare Part B, you will also need to pay a deductible, which is $233 for 2022. After this, Medicare will provide reimbursement. But there is still coinsurance, which means you will share costs with your medical insurer. You will typically need to pay 20% of the costs of the sleep study, and Medicare will reimburse for the remaining 80%.

Some states like Massachusetts and California provide coverage for sleep studies through their Medicaid programs. For more details, check out the Medicaid program in your state.

If you do not qualify for Medicare or Medicaid, private insurers like United Healthcare and Aetna will typically provide coverage. But there may be different requirements. An insurance company can require that you use an at-home test before getting a sleep study at a lab.

How can you save on the cost of a sleep study?

An at-home sleep system will be the most affordable option. You may even buy refurbished or used sleep-study equipment. Sites include Repap.com and 1800CPAP.com. But there is a risk with this option. You may get equipment that is faulty.

Sleep study devices can cost anywhere between $100 to $500 online. You can contact your insurance company to determine if they will cover the cost. Below are some of the common at-home sleep-study devices.

• Breathing sensor: This is a nasal prong that you insert into your nostrils. The device measures air pressure for your breathing.

• Effort belt: You attach this to your chest, and the device measures respiration.

• Pulse oximeter: You can put this on your finger, nose, ears, or toes. The device collects data on the saturation of oxygen in your red blood cells.

• Sleep tracker: This can be a wearable, bedside device, or bed sensor. This system can measure sleep stage, body position, oxygen levels, and heart rate.

To get the best results, you should talk to a doctor. They will recommend the right systems to use and what information to log. The doctor will then make a diagnosis.

However, if a doctor recommends that you use a sleep lab, then you should still shop around. The prices can range widely from one sleep center to another.

Some health centers provide affordable or free medical services for sleep studies. You can check the Health Resources Services Administration (HRSA) directory for options.

Is a sleep study worth it?

Sleep disorders can lead to health challenges. If you are facing irregular sleep patterns, it’s important to consult with a doctor regarding next steps.

The CDC has conducted an extensive review of clinical studies on the effectiveness of sleep studies. There is no “gold standard” like there is for cancer — which uses tissue biopsies — and other diseases.

But the research shows that sleep studies generally provide an effective diagnosis. According to the CDC, sleep studies will “identify a significant proportion of patients with OSA who will respond clinically to CPAP and will exclude a significant proportion of those who will not.”

Because of this assessment, Medicare agreed to provide coverage for sleep studies. This has also been the case with various Medicaid programs.