The new guidelines, which appear in the Aug. 5 issue of Annals of Internal Medicine, are based on research findings from the last several decades.
The guidelines recommend that patients undergo a "sleep study," either in a sleep lab or with a portable monitor, if they are sleepy during the day for an unexplained reason. The guidelines call this a "weak recommendation" based on "low-equality evidence."
Holty said the portable monitors have become more common because they're cheap to use -- around $200 to $250. Insurers often refuse to pay for sleep studies in laboratories that can cost about $1,100, he said.
Using a portable monitor instead of a sleep laboratory means "you're not paying someone to be up at night monitoring you, you're not having to pay for the rent and the electricity," Holty said. The portable monitors also offer an alternative to patients who don't live near a sleep lab, he added.
Dr. Michael Thorpy, director of the Sleep-Wake Disorders Center at Montefiore Medical Center in New York City, pointed out that the portable home monitors don't provide useful data in about 20 percent of patients. The portable monitors also can be unreliable at diagnosing sleep apnea in patients with mild forms of the condition, he added.
Insurers who insist on the machines "need to read these guidelines to understand that there are limitations," he said.
As for treatment, patients are often prescribed masks that keep their airways open through pressurized air that enters their nostrils. But many patients can't tolerate the masks and refuse to use them unless their sleep worsens.
Successfully treating sleep apnea can make a big difference to patients, Thorpy said. "They see improvement and not just in terms of their overall health benefits. They come in and say they're so grateful because we've dramatically changed their lives."