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Home Sleep Apnea Tests: Complete Guide for Belgium
Suspected sleep apnea? Diagnosis does not necessarily require a hospital night. Reliable tests can be done at home or with simple questionnaires. This guide explains all available options in Belgium.
How to get a sleep apnea test?
In Belgium, the diagnostic path usually starts with the GP. Here are the steps:
- Consult your GP: describe your symptoms (fatigue, snoring, sleepiness). Ask your sleep partner to note their nocturnal observations - that is valuable information.
- Screening questionnaires: your doctor may use the ESS, STOP-BANG or Berlin questionnaire to assess your apnea risk.
- Specialist referral: if risk is high, your GP refers you to a pulmonologist or sleep specialist who prescribes the appropriate sleep test.
- Sleep study: ambulatory polygraphy at home or polysomnography in a sleep center, depending on your profile.
Ambulatory ventilatory polygraphy (home test)
Ventilatory polygraphy - also called ambulatory polygraphy or home recording - is the most commonly prescribed sleep apnea screening test in Belgium. It is done at home, in your own bed.
How does it work?
The provider or sleep center hands you a small portable device that you fit yourself before going to bed. Through the night it records:
- Airflow (through a nasal cannula)
- Thoracic and abdominal movements (bands)
- Oxygen saturation / SpO2 (finger oximeter)
- Heart rate
- Sleep position
The next morning you return the device. The technician analyses the data and calculates your AHI/AHIO. The results are given at a follow-up consultation.
Advantages and limitations
- Advantages: comfort of your own bed, quick results, less expensive than PSG, reimbursed by Belgian health insurance
- Limitations: fewer parameters than PSG, no EEG. It can slightly underestimate the AHI, because it divides by total recording time rather than by actual sleep time. It is not suitable for complex cases
Polysomnography (PSG) in a sleep center
Polysomnography is the reference sleep study (gold standard). It is done by spending a night in an accredited sleep center, supervised by a technician.
In addition to the polygraphy parameters, PSG records:
- EEG (electroencephalogram): measures brain activity and identifies sleep stages
- EOG: eye movements (essential to detect REM sleep)
- EMG: muscle activity (chin and legs)
- Posture and body movements
- A microphone to record snoring
PSG is recommended when a sleep disorder other than apnea is suspected: narcolepsy, restless legs, complex parasomnias. It is also recommended in children, or when polygraphy gives a borderline result.
Overnight oximetry
Overnight oximetry is an even simpler test. You wear a finger oximeter through the night, which continuously records oxygen saturation and heart rate.
It is sometimes offered as a first level of screening, particularly for high-risk patients. Repeated nocturnal desaturation (SpO2 dropping below 90 %) is a strong warning sign. However, oximetry alone is not sufficient to diagnose apnea - it must be followed by polygraphy or PSG.
Screening questionnaires
Before prescribing a sleep study, your doctor can assess your apnea risk with validated questionnaires. The three main ones:
Epworth Sleepiness Scale (ESS)
A questionnaire of 8 everyday situations measuring daytime sleepiness. For each situation you rate your chance of dozing from 0 (never) to 3 (high chance). The total score runs from 0 to 24.
- Score 0-10: normal sleepiness
- Score 11-15: excessive sleepiness - consultation recommended
- Score ≥ 16: severe sleepiness - urgent consultation
STOP-BANG questionnaire
8 Yes/No questions on apnea risk factors:
- Snoring - Do you snore loudly?
- Tired - Are you often tired during the day?
- Observed - Has anyone observed you stop breathing during sleep?
- Pressure - Do you have high blood pressure (or are you treated for it)?
- BMI - BMI > 35?
- Age - Over 50?
- Neck - Neck circumference > 40 cm?
- Gender - Are you male?
Score ≥ 3: intermediate apnea risk. Score ≥ 5: high risk - consultation recommended.
Berlin questionnaire
A questionnaire in 3 categories (snoring and observed apneas, sleepiness and fatigue, hypertension and BMI). A high-risk score in at least 2 of the 3 categories indicates a significant apnea risk. Sensitivity about 86 % (Netzer et al., Annals of Internal Medicine 1999).
What to do after results?
If your AHI/AHIO confirms moderate to severe sleep apnea (≥ 15/hour), your doctor will propose treatment. The reference treatment is CPAP.
Our CPAP devices available to buy:
Browse our Auto CPAP devices and CPAP masks.
No alcohol the night before, and this matters
Alcohol suppresses REM sleep and worsens apnoeas in the first half of the night. A drink the evening before a recording does not give you a bad night: it gives you somebody else's night. Yet it is that recording which decides your treatment, your pressure and, in Belgium, your access to the reimbursement scheme. Avoid the afternoon nap and coffee after midday for the same reason: the aim is your usual night, not your best one and not your worst.
Frequently asked questions about home sleep apnoea testing
After prescription by your doctor, the sleep centre or provider gives you a small portable device. You install it yourself at bedtime: a nasal cannula to measure airflow, two chest and abdominal bands for respiratory movements, and a finger oximeter for oxygen saturation. You then sleep normally in your own bed. The next morning you return the device. Analysis takes a few days and results are shared during a follow-up consultation.
For most obstructive apnoea cases, yes. Ambulatory polygraphy reliably detects moderate to severe apnoea and is the first-line exam recommended by learned societies. It has two limitations: it does not measure EEG (so no sleep stages) and may slightly underestimate AHI by dividing events by total recording time rather than actual sleep time. Polysomnography remains recommended for complex or paediatric cases.
In Belgium, ambulatory polygraphy is largely reimbursed by mutual insurance. The remaining out-of-pocket cost varies based on your status (regular insured or BIM/OMNIO) and whether the prescription comes from a GP or specialist. Expect generally between 30 and 80 EUR remaining cost. Verify exact conditions with your mutual fund before prescription.
Yes, your GP can prescribe an ambulatory respiratory polygraph as a first-line exam. This is the recommended pathway for moderate-risk patients. For more complex cases - suspected central apnoea, severe respiratory or cardiac comorbidity, suspected other sleep disorders - your GP will refer you to a pulmonologist or sleep specialist.
No. These questionnaires are screening tools, not diagnostic instruments. They help assess your risk level and decide whether to prescribe a sleep study, but cannot confirm or rule out apnoea. A STOP-BANG of 5/8 for example indicates high risk but must always be followed by polygraphy or polysomnography to establish the diagnosis. See our screening tests page.
A single night is sufficient in the vast majority of cases. The ambulatory polygraph records one complete night and is generally representative of your usual sleep. If the first night is judged technically insufficient (signal loss, very short sleep, cannula problem), a second night may be offered. Some centres prescribe two or three nights upfront for atypical patients, but this remains the exception.
The sleep centre or provider technician downloads the device data and analyses it. A doctor then validates the interpretation and calculates your AHI. The report is sent to your prescribing doctor, generally within 1 to 3 weeks. You will be invited to a feedback consultation during which your doctor explains the results, their meaning and therapeutic options if apnoea is confirmed.