What is the difference between a Level 1 and Level 2 Sleep Study?

Understanding the different levels of sleep studies is important. Different sleep clinics have their own methods of categorising their sleep studies, using groups known as levels to distinguish between them. Some clinics use only Level 1 and Level 2, while others use Level 1, Level 2 and Level 3. For clinics that use Levels 1-3, the difference between Level 1 and Level 2 Sleep Studies lies in the setting and complexity of the monitoring process.

Level 1 Sleep Studies are conducted in a controlled sleep clinic or laboratory environment, involving an array of electrodes and sensors to record detailed data on brain activity, eye movement, and heart function. They are best suited for diagnosing complex sleep disorders.

In contrast, Level 2 Sleep Studies are designed for home use and typically involve simpler monitoring equipment. This option is more convenient and cost-effective, making it suitable for identifying common sleep disorders like sleep apnea.

Therefore, the main difference between level 1 and level 2 sleep studies is the setting in which they are conducted and the extent of monitoring involved. The former is conducted in a clinical environment with more extensive monitoring, while the latter takes place in the home, with less extensive monitoring.

What are sleep studies?

Sleep studies are specialised diagnostic procedures used to monitor and analyse an individual’s sleep patterns and behaviours. These studies employ various monitoring devices to record essential physiological data while the person sleeps, including brain activity, eye movement, heart function, breathing patterns, and muscle activity.

The gathered information helps healthcare professionals assess the quality and quantity of a person’s sleep, identify sleep disorders, and guide treatment decisions. Sleep studies are invaluable tools for understanding and addressing issues related to sleep and overall well-being.

How does Manse Medical categorise their sleep studies?

Level 1 – Sleep Tests

The first category is Level 1 Attended Sleep Tests, where patients are admitted to a sleep clinic or hospital. Here, Sleep Technologists oversee the entire process, educate patients, set up overnight sleep studies, and monitor them throughout the night.

Level 1 sleep studies are also conducted for CPAP titration, particularly for patients previously diagnosed with Obstructive Sleep Apnoea (OSA), to determine the optimal CPAP pressure and provide comprehensive education. For patients using CPAP and requiring a follow-up sleep study, bringing their own CPAP mask is advised. The admin team offers detailed information on the process and what to bring for Level 1 attended sleep studies.

Level 2 – At Home Sleep Tests

The second category is Level 2 – At Home Sleep Tests. In this case, patients are referred for a home sleep test if they either meet certain criteria or have a high probability of moderate-to-severe Obstructive Sleep Apnoea (OSA). While home sleep tests are not as comprehensive as attended Level 1 studies, they can effectively diagnose moderate-to-severe OSA.

Patients attend a Manse Medical location or an approved partner’s facility to be set up with sleep study equipment, which they wear home for the night. The collected data is then analysed by Manse Medical’s Sleep Physicians. Depending on the findings, patients may be referred back to their GP for result discussions, or if significant OSA is confirmed, they may be recommended an attended Level-1 CPAP titration sleep study for treatment trials. The admin team provides comprehensive information on the process and what to bring for home sleep tests.

What kinds of sleep studies are provided by Manse Medical?

CPAP titration

CPAP titration sleep studies are specialised tests conducted to determine the optimal Continuous Positive Airway Pressure (CPAP) settings for patients diagnosed with Obstructive Sleep Apnoea (OSA). This type of study is always performed in a sleep clinic or hospital. During this study, a sleep technologist will closely monitor a patient while they use a CPAP machine, which delivers a constant stream of air pressure to keep the airway open during sleep. The study aims to find the precise pressure level needed to effectively manage OSA, ensuring a restful night’s sleep.

Diagnostic sleep study

A diagnostic sleep study, often referred to as a Level-1 sleep study, is a comprehensive examination conducted in a sleep clinic or hospital setting. It involves the use of various monitoring devices to assess a wide range of sleep parameters, making it the gold standard for diagnosing sleep disorders. These studies provide valuable insights into sleep quality and can identify issues such as sleep apnea, narcolepsy, or restless leg syndrome.

Home sleep test

Home sleep tests are a more convenient and cost-effective alternative to in-lab, attended sleep studies. Home sleep tests are often referred to as level 2 sleep studies. These tests are typically recommended when there is a suspicion of moderate-to-severe Obstructive Sleep Apnoea. Patients are provided with portable sleep monitoring equipment, which they wear at home for a night of sleep. The collected data is then analysed by medical professionals, allowing for the diagnosis of some sleep disorders, particularly OSA.

Maintenance of Wakefulness Test (MWT)

The MWT assesses an individual’s ability to stay awake and alert during the day, particularly in professions where wakefulness is critical, such as commercial drivers or airline pilots. During an MWT, participants are asked to remain awake in a controlled environment, and their ability to resist sleep is measured. This test helps evaluate excessive daytime sleepiness and safety in various occupational settings.

Multiple Sleep Latency Test (MSLT)

MSLT is a diagnostic sleep study designed to assess the severity of excessive daytime sleepiness and identify conditions like narcolepsy. It measures how quickly a person falls asleep during daytime naps in a controlled environment. The test quantifies sleep propensity and the presence of rapid eye movement (REM) sleep during daytime naps, aiding in the diagnosis and treatment of narcolepsy or other hypersomnia disorders.

Attended Level-1 Sleep Studies

Attended Level-1 sleep studies are the most comprehensive form of sleep tests conducted in sleep clinics or hospitals. These studies involve close monitoring by Sleep Technologists throughout the night. Various monitoring devices, including EEG, EOG, and EKG electrodes, are used to record brain activity, eye movement, breathing patterns and heart function. They provide in-depth insights into sleep patterns, making them the preferred choice for diagnosing complex sleep disorders and ensuring minimal disturbances during the study.


What to expect during a level 1 or level 2 sleep study

During a level 1 sleep study, you can expect a comprehensive evaluation of your sleep in a controlled clinical environment. Highly trained technicians will attach various monitoring devices to you to record brain activity, eye movement, heart function, and other parameters, ensuring a detailed assessment.

In contrast, a level 2 sleep study, conducted at home, involves a more simplified setup with portable equipment. You’ll be instructed on how to wear and use the monitoring devices during the night, after which the data collected will be analysed by sleep specialists.

Level 1 and Level 2 Sleep Studies – Frequently Asked Questions

What kind of equipment is used in Level 1 sleep studies?

In Level 1 studies, a wide array of monitoring devices, such as electroencephalography (EEG), electrooculography (EOG), and electrocardiography (EKG) electrodes, are used to record brain activity, eye movement, body movement, breathing patterns and heart function.

What equipment is involved in Level 2 sleep studies?

Level 2 studies involve simpler and more portable monitoring equipment, such as a portable sleep monitor, designed for use in the home environment.

Which sleep disorders can be diagnosed with Level 1 studies?

Level 1 studies are often used to diagnose complex sleep disorders, such as narcolepsy, and provide comprehensive data for more in-depth analysis.

What is the purpose of Level 2 sleep studies?

Level 2 studies are commonly used for diagnosing common sleep disorders like obstructive sleep apnea (OSA), making them a more accessible and cost-effective option.

How do I choose between a Level 1 and a Level 2 sleep study?

The choice between Level 1 and Level 2 studies depends on factors such as the complexity of your sleep issues, your comfort and convenience preferences, and your healthcare provider’s recommendations.

Are Level 1 sleep studies more expensive than Level 2 studies?

Level 1 studies, conducted in a sleep clinic or hospital, may be more expensive due to the detailed monitoring equipment and the professional staff involved. Level 2 studies, conducted at home, are generally more cost-effective.

Which study is more convenient for patients?

Level 2 studies are often considered more convenient. This type of study, also known as a home sleep test, eliminates the need for overnight stays and complex setup processes. Instead, patients can simply set up portable equipment before going to bed and enjoy a restful night’s sleep in familiar surroundings.

Do both Level 1 and Level 2 studies provide accurate results?

Both types of studies can provide accurate results, but the choice between them should be based on the specific sleep disorder being investigated and the patient’s individual circumstances.