Sleep Medicine · OSA · Clinical Pearl
A negative home sleep study does not always rule out OSA
Lede: When clinical suspicion remains high, a single negative or inconclusive HSAT should not end the diagnostic evaluation.
Why it matters
HSAT is appropriate for selected uncomplicated adults at increased risk of moderate-to-severe OSA, but it does not measure every physiologic signal captured by laboratory polysomnography and may underestimate disease in some settings. AASM guidance recommends polysomnography after a negative, inconclusive, or technically inadequate HSAT when OSA remains clinically suspected.
The pearl
A negative HSAT is a test result—not a veto on the clinical history. If pretest probability remains substantial, move to polysomnography.
