Multinight Prevalence, Variability, and Diagnostic Misclassification of Obstructive Sleep Apnea

Abstract

At a Glance Commentary (191/200) Scientific Knowledge on the SubjectRecent studies that have assessed obstructive sleep apnea (OSA) over several consecutive nights indicate that OSA severity can vary markedly from night-to-night which may have important implications for diagnosis, management, and prevalence estimates. Prior to recent advances in non-invasive home sleep monitoring technology, it was not feasible to examine night-to-night variation in OSA severity and its potential impact on diagnostic classification and prevalence estimates over extended periods in the home setting at scale.

Obstructive sleep apnea is associated with specific gut microbiota species and functions in the population-based Swedish CardioPulmonary bioImage Study (SCAPIS)

“…However, obstructive sleep apneas are more common in the general population 52 . An assessment for OSA based on a single night may result in a certain degree of exposure misclassification 53 , which could affect the precision, but would not bias our estimates. The T90 parameter is not able to differentiate hypoxia caused by OSA from nocturnal hypoxia of other etiologies.…”

How Many More Nights? Diagnosing and Classifying Obstructive Sleep Apnea Using Multinight Home Studies

“…Clearly this seems most important when differentiating between no sleep apnea and mild OSA, and mild and moderate OSA. Here Lechat and colleagues add important clarity ( 6 ). They showed that an average of 21% of diagnoses (no OSA vs. OSA) would be false negative on a single night study.…”

“…In this issue of the Journal , Lechat and colleagues (pp. 563–569 ) set out to assess the prevalence of OSA (using a cutoff for diagnosis of AHI ⩾15), and night-to-night variation in AHI over a far longer period than in previous studies, and with a large sample size to understand the impact on diagnostic certainty ( 6 ). This was made feasible by using a contactless noninvasive diagnostic device (Withings Sleep Analyzer) placed under the user’s mattress at home.…”

Obstructive sleep apnea endotypes and their postoperative relevance

“…Obstructive sleep apnea (OSA), characterized by repetitive upper airway collapse during sleep, is estimated to affect nearly 1 billion people worldwide 1,2. OSA is a common comorbidity in people undergoing surgical procedures, with rates as high as 91% in those undergoing bariatric surgery 3.…”

“…airway collapse during sleep, is estimated to affect nearly 1 billion people worldwide. 1,2 OSA is a common comorbidity in people undergoing surgical procedures, with rates as high as 91% in those undergoing bariatric surgery. 3 OSA is an important risk factor for adverse postoperative outcomes including cardiac complications, opioid-induced ventilatory depression, and unplanned intensive care unit transfers.…”