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Certain conditions and medications can make home sleep testing inaccurate or unsafe, requiring in-lab polysomnography instead. Opioids (e.g., morphine, codeine) can induce central apneas; alpha blockers (e.g., doxazosin) and short-acting nitrates (e.g., nitroglycerin) may interfere with signal detection in HSAT devices. Serious heart/lung diseases (e.g., heart failure, COPD), and severe insomnia (difficulty falling/staying asleep most nights for months) are also exclusions due to complexity and need for monitoring.