Novel home-testing devices for diagnosing obstructive sleep apnoea hypopnoea syndrome are a cost-effective alternative to oximetry in adults, but their cost-effectiveness compared to respiratory polygraphy is uncertain.
A systematic review and economic evaluation found that in adults, novel home-testing devices for obstructive sleep apnoea hypopnoea syndrome had generally high sensitivity (80-100%) but variable specificity (25-100%). In the base-case economic analysis, all six novel devices were less costly than respiratory polygraphy but slightly less effective, while compared to oximetry they were more costly and more effective with incremental costs below £10,000 per quality-adjusted life-year gained.
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Novel home-testing devices for diagnosing obstructive sleep apnoea hypopnoea syndrome are a cost-effective alternative to oximetry in adults, but their cost-effectiveness compared to respiratory polygraphy is uncertain. The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 34/100 (low).
The Claim
Novel home-testing devices for diagnosing obstructive sleep apnoea hypopnoea syndrome are a cost-effective alternative to oximetry in adults, but their cost-effectiveness compared to respiratory polygraphy is uncertain.
This conclusion is most relevant to: Adults with suspected obstructive sleep apnoea hypopnoea syndrome; limited data in children (only three studies, all in clinic)..
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Home-testing devices for diagnosing obstructive sleep apnoea hypopnoea syndrome - a systematic review and economic evaluation. (Health technology assessment (Winchester, England), 2026) —
How It Works
The proposed biological pathway:
- ▸Novel home-testing devices are smaller, easier to use, and more comfortable than traditional diagnostic equipment.
- ▸They are used by patients at home to record breathing, heart rate, and oxygen levels during sleep.
- ▸The devices aim to reduce test failures and delays associated with traditional in-clinic or wired home tests.
- ▸Improved usability and home setting may lead to more successful diagnostic recordings and cost savings.
Who Might Benefit
Evidence fit by population:
- ▸Adults with suspected obstructive sleep apnoea hypopnoea syndrome; limited data in children (only three studies, all in clinic).
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Diagnostic test accuracy data were uncertain, with estimates varying within and between studies; most studies were conducted in clinic rather than home settings.
- ▸Limited data on many outcomes beyond diagnostic accuracy and cost-effectiveness; insufficient evidence for children.
- ▸Some outcomes were not modelled in the economic evaluation, and additional analyses highlighted the extent of uncertainty.
Frequently Asked Questions
Are novel home-testing devices accurate for diagnosing sleep apnoea?▼
In adults, sensitivity was generally high (80-100%), but specificity varied widely (25-100%), with many estimates in the 70-80% range. There is uncertainty in the accuracy estimates.
Are novel home-testing devices cost-effective for the NHS?▼
Compared to oximetry, all six devices were more costly but more effective, with incremental costs below £10,000 per QALY gained, suggesting cost-effectiveness. Compared to respiratory polygraphy, they were less costly but slightly less effective, and cost-effectiveness was uncertain.
Can novel home-testing devices be used in children?▼
There is insufficient evidence to assess their cost-effectiveness in children; only three studies included children, and all were conducted in clinic rather than home settings.
What are the main limitations of the evidence on novel home-testing devices?▼
Most studies were done in clinic rather than home settings, diagnostic accuracy data were uncertain, and limited data were available on other outcomes. More research is needed on home use and in children.
References
- 1.Peters J, Shepherd J, Maund E, Grigore B, Woods L, Lord J, Scott DA, Hyde C. “Home-testing devices for diagnosing obstructive sleep apnoea hypopnoea syndrome - a systematic review and economic evaluation..” Health technology assessment (Winchester, England), 2026. PMID: 42661570 DOI: 10.3310/GJJS3014