Clinical diagnosis of sleep apnea based on single night of polysomnography vs. two nights of polysomnography

Ahmadi, Negar; Shapiro, Gilla K.; Chung, Sharon A.; Shapiro, Colin M.

doi:10.1007/s11325-008-0234-2

Cited by 117 publications

(87 citation statements)

References 15 publications

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“…33 Our review identified nineteen studies that evaluated the performance of the Berlin Questionnaire against PSG in the identification of patients with OSA. [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] The studies were conducted in a wide variety of geographic locations including Brazil, 38 Canada, 34,42 Greece, 37 Iran, 36 Korea, 40 Turkey, 43 and the United States. 41,44 Various patient populations were considered, including those in primary care clinics, sleep clinics, the veteran population, and patients with cardiac disease.…”

Section: Discussionmentioning

confidence: 99%

“…34,[129][130][131] There was a wide range of OSA severity within the populations included in the four studies (AHI range: 7-34). None of the studies included data on body position during the 2 nights of PSG.…”

Section: Discussionmentioning

confidence: 99%

“…131 Only one of the studies indicated that PSG scorers were blinded to the other PSG result. ahi (niGht-to-niGht variaBility): A meta-analysis of four studies compared AHI data between 2 consecutive nights of PSG 34,[129][130][131] (see supplemental material, Figure S28 and Table S66) and found the mean difference in the AHI between the 2 nights was 0.14 (95% CI: −1.86 to 2.15), which was not statistically or clinically significant. Nonetheless, a subset of individuals had considerable night-to-night variability in their AHIs, which could have potential clinical implications if the AHI crosses a treatment threshold only during the second PSG.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, a subset of individuals had considerable night-to-night variability in their AHIs, which could have potential clinical implications if the AHI crosses a treatment threshold only during the second PSG. Using an AHI cutoff of ≥ 5 to diagnose OSA, three of the studies 34,130,131 identified that 9.9% to 25% of subjects had an AHI < 5 on the first PSG but an AHI ≥ 5 only on the second PSG. Likewise, using an AHI cutoff of ≥ 15 or 20 as a potential treatment threshold, 2 of the studies 34,130 observed that 7.6% and 25% of subjects crossed this threshold only on the second study.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Kapur

Auckley

Chowdhuri

et al. 2017

Journal of Clinical Sleep Medicine

2,037

1,498

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Introduction: This guideline establishes clinical practice recommendations for the diagnosis of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines on the evaluation and treatment of sleep-disordered breathing in adults. Methods: The AASM commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use. In addition, the task force adopted foundational recommendations from prior guidelines as "good practice statements", that establish the basis for appropriate and effective diagnosis of OSA. The AASM Board of Directors approved the final recommendations. Recommendations:The following recommendations are intended as a guide for clinicians diagnosing OSA in adults. Under GRADE, a STRONG recommendation is one that clinicians should follow under most circumstances. A WEAK recommendation reflects a lower degree of certainty regarding the outcome and appropriateness of the patient-care strategy for all patients. The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources. Good Practice Statements:Diagnostic testing for OSA should be performed in conjunction with a comprehensive sleep evaluation and adequate follow-up. Polysomnography is the standard diagnostic test for the diagnosis of OSA in adult patients in whom there is a concern for OSA based on a comprehensive sleep evaluation. Recommendations:1. We recommend that clinical tools, questionnaires and prediction algorithms not be used to diagnose OSA in adults, in the absence of polysomnography or home sleep apnea testing. (STRONG) 2. We recommend that polysomnography, or home sleep apnea testing with a technically adequate device, be used for the diagnosis of OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. (STRONG) 3. We recommend that if a single home sleep apnea test is negative, inconclusive, or technically inadequate, polysomnography be performed for the diagnosis of OSA. (STRONG) 4. We recommend that polysomnography, rather than home sleep apnea testing, be used for the diagnosis of OSA in patients with significant cardiorespiratory disease, potential respiratory muscle weakness due to neuromuscular condition, awake hypoventilation or suspicion of sleep related hypoventilation, chronic opioid medication use, history of stroke or severe insomnia. (STRONG) 5. We suggest that, if clinically appropriate, a split-night diagnostic protocol, rather than a full-night diagnostic protoc...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Kapur

Auckley

Chowdhuri

et al. 2017

Journal of Clinical Sleep Medicine

2,037

1,498

View full text Add to dashboard Cite

show abstract

“…It is more prevalent than asthma and diabetes mellitus in adults (Ahmadi et al, 2009). OSAHS is associated with several cardiovascular diseases including arterial hypertension, acute myocardial infarction, and stroke, and increases cardiovascular mortality and morbidity (Yaggi et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis demonstrates lack of association between the ACE gene I/D polymorphism and obstructive sleep apnea-hypopnea syndrome occurrence and severity

Feng¹,

Ri²,

Wan³

et al. 2013

Genet. Mol. Res.

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ABSTRACT. Published data on a possible association between the angiotensin-converting enzyme (ACE) gene I/D polymorphism and obstructive sleep apnea-hypopnea syndrome (OSAHS) occurrence and its severity risk are inconclusive. We performed a meta-analysis of case-control studies published in English or Chinese. Thirteen studies, totaling 1361 cases and 1373 controls, were investigated for association of the ACE I/D polymorphism with OSAHS. We also made a study of ACE I/D with OSAHS severity risk, including 879 mild/moderate OSAHS patients and 357 severe OSAHS patients. A random-effects model was used, irrespective of between-study heterogeneity. Study quality was assessed in duplicate. Overall, the ACE I/D polymorphism was not significantly associated with an increase in OSAHS risk [odds ratio (OR) = 1.21; 95% confidence interval (95%CI) = 0.88-1.65; P = 0.24]. In subgroup analysis by ethnicity, comparison of alleles I with D demonstrated a 58% (nonsignificantly) increased risk for OSAHS in Chinese (OR = 1.58; 95%CI = 0.92-2.70; P = 0.09). We also found that there was no significant association between ACE I/D and OSAHS severity risk. No publication biases were observed. This meta-analysis suggests that there is no significantly increased risk for OSAHS occurrence or severity associated with the ACE I/D polymorphism.

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Association Between Obstructive Sleep Apnea and Brain White Matter Hyperintensities in a Population-Based Cohort in Germany

et al. 2021

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IMPORTANCEUnderlying pathomechanisms of brain white matter hyperintensities (WMHs), commonly observed in older individuals and significantly associated with Alzheimer disease and brain aging, have not yet been fully elucidated. One potential contributing factor to WMH burden is chronic obstructive sleep apnea (OSA), a disorder highly prevalent in the general population with readily available treatment options. OBJECTIVE To investigate potential associations between OSA and WMH burden. DESIGN, SETTING, AND PARTICIPANTS Analyses were conducted in 529 study participants of the Study of Health in Pomerania-Trend baseline (SHIP-Trend-0) study with complete WMH, OSA, and important clinical data available. SHIP-Trend-0 is a general population-based, cross-sectional, observational study to facilitate the investigation of a large spectrum of common risk factors, subclinical disorders, and clinical diseases and their relationships among each other with patient

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Clinical diagnosis of sleep apnea based on single night of polysomnography vs. two nights of polysomnography

Cited by 117 publications

References 15 publications

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Meta-analysis demonstrates lack of association between the ACE gene I/D polymorphism and obstructive sleep apnea-hypopnea syndrome occurrence and severity

Association Between Obstructive Sleep Apnea and Brain White Matter Hyperintensities in a Population-Based Cohort in Germany

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