PSG vs HSAT

PSG vs HSAT: What Sleep Labs and Physicians Need to Know
Sleep diagnostics has evolved significantly over the past decade. Two primary testing modalities are
now commonly used to evaluate sleep-disordered breathing and other sleep conditions:
Polysomnography (PSG) and Home Sleep Apnea Testing (HSAT). While both serve important roles,
they differ substantially in data collection, scoring requirements, clinical applications, and operational
demands.
Understanding these differences is essential for accurate diagnosis, compliance, and workflow
efficiency.
What Is Polysomnography (PSG)?
Polysomnography (PSG) is the gold standard for comprehensive sleep evaluation and is performed in
an accredited sleep laboratory under the supervision of trained sleep technologists.
PSG includes EEG, EOG, chin and limb EMG, ECG, airflow, respiratory effort, pulse oximetry, snoring,
body position, and video/audio monitoring.
PSG allows clinicians to assess sleep stages, sleep architecture, arousals, obstructive and central
apneas, hypopneas per AASM criteria, RERAs, periodic limb movements, parasomnias, nocturnal
seizures, and complex sleep disorders.
Because of its complexity, PSG scoring requires advanced training and strict adherence to AASM
scoring rules. Even minor inconsistencies can impact AHI, RDI, and final interpretation.
What Is Home Sleep Apnea Testing (HSAT)?
Home Sleep Apnea Testing (HSAT) is designed to evaluate suspected obstructive sleep apnea in
select adult patients.
HSAT typically records airflow, respiratory effort, oxygen saturation, heart rate, snoring, and body
position depending on the device used.
HSAT can assess respiratory events, oxygen desaturations, and estimated AHI or REI. However, it
does not include EEG, does not provide true sleep staging, relies on total recording time, and has
limited ability to detect central events.
HSAT is not appropriate for patients with significant comorbidities, neuromuscular disease, CHF,
COPD, pediatric populations, parasomnias, or seizure disorders.
PSG vs HSAT: Key Differences
PSG is performed in-lab with full EEG and sleep architecture analysis, while HSAT is home-based and
focused primarily on respiratory parameters. PSG provides accurate detection of central events and
complex disorders, whereas HSAT is best suited for uncomplicated obstructive sleep apnea cases.
Why Accurate Scoring Matters
Regardless of modality, scoring accuracy directly impacts diagnosis, treatment decisions,
reimbursement, and patient outcomes. Sleep labs frequently face scoring backlogs, staffing shortages,
and inconsistent scoring across technologists.
How MySleepScoring.com Supports Sleep Labs and Physicians
MySleepScoring.com specializes in remote PSG and HSAT scoring performed exclusively by certified
RPSGTs. We provide AASM-compliant scoring, consistent accuracy, fast turnaround times,
HIPAA-compliant workflows, and seamless integration with lab software platforms.
Our mission is to reduce operational burden while maintaining scoring excellence.
Learn more at www.MySleepScoring.com