Night-to-night variability in obstructive sleep apnea using peripheral arterial tonometry: a case for multiple night testing

Tschopp, Samuel; Wimmer, Wilhelm; Caversaccio, Marco; Borner, Urs; Tschopp, Kurt

doi:10.5664/jcsm.9300

Cited by 19 publications

(9 citation statements)

References 36 publications

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“…Misclassification probabilities derived in this study are also in accordance with published data, where misclassification probabilities of a 1-night diagnosis range between 10 and 60% (9)(10)(11)(12)(13)(14).…”

Section: Discussionsupporting

confidence: 90%

“…This is concordant with earlier reports that indicate between 20-60% of people with OSA may be misdiagnosed based on a single night study depending on the sampled population (e.g. sleep clinic vs. general population) (10)(11)(12)(13)(14)(15). However, previous studies were limited in sample size, and misdiagnosis rates were only calculated on a small (<14) number of nights, which limits generalizability.…”

Section: Introductionsupporting

confidence: 89%

See 1 more Smart Citation

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

Lechat

Naik

Reynolds

et al. 2022

Am J Respir Crit Care Med

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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.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionsupporting

confidence: 89%

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

Lechat

Naik

Reynolds

et al. 2022

Am J Respir Crit Care Med

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“…Repeated, non-disturbing measurements in the familiar sleep surroundings of a patient’s home to quantify the respiratory status was an advantage of our study methods. Although Tschopp et al [ 28 ] found no evidence of first night effect and night-to-night variability in respiratory polygraphy while using Watch-PAT, Le Bon et al [ 29 ] observed the first-night effect in their PSG study. We performed the sleep study for two nights for each MOA experiment and for all participants to strengthen the accuracy of our study.…”

Section: Discussionmentioning

confidence: 99%

Effect of Different Maxillary Oral Appliance Designs on Respiratory Variables during Sleep

Soe

Ishiyama

Nishiyama

et al. 2022

IJERPH

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This study aimed to analyze the efficacy of maxillary oral appliance (MOA) designs on respiratory variables during sleep. At baseline, 23 participants underwent a sleep test with a portable device for two nights and were categorized as participants with mild obstructive sleep apnea (mild-OSA) (n = 13) and without OSA (w/o-OSA) (n = 10). Three types of MOAs, standard-OA (S-OA), palatal covering-OA (PC-OA), and vertically increasing-OA (VI-OA), were each worn for three nights, and sleep tests with each MOA were performed with a portable device for two nights. Based on the average of the respiratory event index (REI) values for the two nights for each MOA, w/o-OSA participants with an REI ≥ 5.0 were defined as the exacerbation group and those with an REI < 5.0 as the non-exacerbation group. In mild-OSA participants, an REI ≥ 15.0 or REI ≥ baseline REI × 1.5 were defined as the exacerbation group and those with an REI < 15.0 and REI < baseline REI × 1.5 were defined as the non-exacerbation group. The percentage of the exacerbation and non-exacerbation groups with MOA was evaluated in the w/o-OSA and mild-OSA participants. The maxillary and mandibular dental-arch dimension was compared by dentition model analysis. The exacerbation group in w/o-OSA participants (n = 10) comprised 10.0% participants (n = 1) with S-OA, 40.0% (n = 4) with PC-OA, and 30.0% (n = 3) with VI-OA. The exacerbation group in the mild-OSA participants (n = 13) comprised 15.4% subjects (n = 2) with S-OA, 23.1% (n = 3) with PC-OA, and 23.1% (n = 3) in VI-OA. In the model analysis for w/o-OSA, the posterior dental arch width was significantly greater in the exacerbation group than in the non-exacerbation group wearing S-OA (p < 0.05). In addition, the ratio of the maxillary to mandibular dental arch width (anterior dental arch width) was significantly greater in the exacerbation group than in the non-exacerbation group for both PC-OA and VI-OA (p < 0.05). In mild-OSA, the maxillary and mandibular dental arch lengths and the ratio of maxillary to mandibular dental arch width (posterior dental arch width) were significantly smaller in the exacerbation group than in the non-exacerbation group for S-OA (p < 0.05). This study confirmed that wearing an MOA by w/o-OSA and mild-OSA participants may increase the REI during sleep and that PC-OA and VI-OA may increase the REI more than S-OA. The maxillary and mandibular dental-arch dimensions may affect the REI when using an MOA.

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“…Beside the significance for first and follow-up diagnostics of SRBD, there is no need for applications in the face and they can register more than one night. This is very important for sleep apnea patients with anxiety disorders and for the problem of night-to-night variability, especially in cases of SRBD related with supine position or REM sleep [6].…”

Section: Sleep-related Breathing Disorders and Snoringmentioning

confidence: 99%

Patienten relevanter Nutzen und Therapieeffekte in der Stimulationstherapie bei schlafbezogenen Atmungsstörungen

Steffen¹

2022

Laryngorhinootologie

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ZusammenfassungFür die Therapie verschiedener schlafbezogene Erkrankungen und das Schnarchen stehen mittlerweile mehrere Neurostimulationsverfahren zur Verfügung. Zur Behandlung der obstruktiven Schlafapnoe (OSA) existieren überwiegend Daten für die atmungsgesteuerte Hypoglossusnervstimulation (HNS), welche die Senkung der Tagesschläfrigkeit in der Epworth Sleepiness Scale (ESS) in zahlreichen Publikationen übereinstimmend und für mehrere Jahre stabil um gut 5 Punkte zeigen konnte. Die schlafbezogene Lebensqualität im Functional Outcomes of Sleep Questionnaire erbringt in mehreren Kohorten eine Besserung um gut 2 Punkte. Zahlreiche Arbeiten zeigen eine durchschnittliche Nutzung von 5 bis 6 Stunden. Unter Berücksichtigung kürzerer Nachsorgeintervalle und kleinerer Kohorten sinkt der ESS bei der unilateralen kontinuierlichen HNS um 4 und bei der bilateralen um 3 Punkte. Zur Behandlung der zentralen Schlafapnoe ist die transvenöse Stimulation der Nervus phrenicus zugelassen, bei welcher sich in einer Schlüsselstudie mit fünfjähriger Nachbeobachtung der ESS um 3 Punkte gesenkt werden konnte. Die Therapiezeit beträgt in einer Arbeit gut 5 Stunden. Mit der enoralen Stimulationstherapie gegen das Schnarchen konnte der ESS um gut 2 Punkte gesenkt und die schlafbezogene Lebensqualität sowohl des Schnarchenden als auch des Bettpartners gesteigert werden. Die Adhärenz zum täglichen Training für die nächtlichen Effekte wird mit 83% angegeben. Sowohl für die HNS, Phrenicusstimulation als auch die enorale Stimulationstherapie laufen weitere (Register-)Studien bzw. sind angekündigt, welche Patienten relevante Endpunkte berücksichtigen.

show abstract

Night-to-night variability in obstructive sleep apnea using peripheral arterial tonometry: a case for multiple night testing

Cited by 19 publications

References 36 publications

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

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

Effect of Different Maxillary Oral Appliance Designs on Respiratory Variables during Sleep

Patienten relevanter Nutzen und Therapieeffekte in der Stimulationstherapie bei schlafbezogenen Atmungsstörungen

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