Evaluation of Home versus Laboratory Polysomnography in the Diagnosis of Sleep Apnea Syndrome

Abstract

The aim of this study was to compare home polysomnography (HoPSG) with laboratory polysomnography (LabPSG) in the diagnosis of sleep apnea syndrome (SAS). A total of 103 patients referred for investigation of SAS underwent two full polysomnographies, using the portable Minisomno device at home and the Respisomnographe in the laboratory (both devices manufactured by the same company). Twenty percent of home-studied device polysomnography (HoSD-PSG) recordings and 5% of LabPSG recordings were excluded from analysis either because of lost data or poor quality data. Sleep stage distribution and subjective quality of sleep were similar by both methods. Using LabPSG, the mean (+/- SD) RDI was 25.7 (+/- 30.6) versus 22.8 (+/- 31.5) using HoSD-PSG (p > 0.05). Absolute differences between the home and laboratory respiratory disturbance index (RDI) were less than 10 for 65% of patients. Discordant RDIs (i.e., differences greater than 10) were observed for 63% of individuals with severe SAS (RDI > 30) versus 22% of those with normal or moderate SAS (RDI </= 30) (p < 0.05). Higher RDI differences were associated with poor airflow signal at home. Forty-seven percent of patients preferred LabPSG. Our results suggest that HoSD-PSG was not feasible for 33% of patients; there was no evidence of a better quality of sleep and recording tolerance at home; the reliability of HoSD-PSG for SAS diagnosis depends on the quality of data obtained under unattended conditions.

Diagnostic test evaluation of a nasal flow monitor for obstructive sleep apnea detection in sleep apnea research

“…These are comparable to those reported with other flow-based single-channel monitors, and they appear no worse than what has been reported with home polysomnography with Type 2 devices, which bear the closest resemblance to an in-laboratory PSG (Gagnadoux, Pelletier-Fleury, Philippe, Rakotonanahary, & Fleury, 2002;Portier et al, 2000). Nevertheless, the wide limits of agreement support the consensus that single-channel devices do not perfectly replicate the scoring from a more complex polysomnographic recording Note-Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value for detecting polysomnogram apnea-hypopnea index (AHI) 2' 10.…”

Autotitrating versus standard noninvasive ventilation: a randomised crossover trial

“…Unattended home polysomnography has been shown to have higher signal failure rates than laboratory studies [21][22][23]. The current authors had a comparatively low signal failure rate, possibly due to the limited mobility of the present patient group and sensor displacement being lessened by mask and headgear use during the studies.…”

Economic arguments for the immediate management of moderate-to-severe obstructive sleep apnoea syndrome

“…However, such a solution would appear to be unfeasible in view of the limited resources devoted to hospitals. Other technical solutions have been proposed including split-night PSG [1,2], which would halve the number of PSGs performed in sleep laboratories, outpatient PSG [3,4], or PSG telemonitored from a sleep laboratory [5], which would replace PSG in the laboratory. The respective advantages of these techniques remain controversial.…”