Thorax, Vol 52, 1068-1073, Copyright © 1997 by Thorax.

Use of home sleep studies for diagnosis of the sleep apnoea/hypopnoea syndrome

AT Whittle, SP Finch, IL Mortimore, TW MacKay and NJ Douglas
Sleep Laboratory, Infirmary of Edinburgh, UK.

BACKGROUND: A study was undertaken to test the hypothesis that unsupervised domiciliary limited sleep studies do not impair the accuracy of diagnosis when used to investigate the sleep apnoea/hypopnoea syndrome (SAHS) and can be cheaper than laboratory polysomnography. METHODS: For validation, 23 subjects with suspected SAHS underwent laboratory polysomnography and a home study (EdenTec 3711) on successive nights. All subjects with > 15 apnoeas + hypopnoeas (A + H)/hour on polysomnography showed > 30 A + H/hour on their home study. Thereafter, in a prospective trial 150 subjects had a home study as the initial investigation and studies showing > 30 events/hour were regarded as diagnostic of SAHS. Those showing fewer events were investigated with polysomnography if necessary. Time to treatment, outcome, and costs of this protocol were compared with those of 75 patients investigated initially with polysomnography. RESULTS: Of the prospective trial subjects, 29% had > 30 A + H/hour and proceeded directly from home study to treatment; 15% without daytime sleepiness were not investigated further. Polysomnography was undertaken to establish a diagnosis in 56% of cases, including 18% whose home studies were unsuccessful. Compared with the 75 control patients, this protocol gave a diagnosis faster (median 18 (range 0-221) versus 47 (0-227) days, p < 0.001) and more cheaply (mean (SD) 164 pounds (104) versus 210 pounds (0), p < 0.001). The proportions offered CPAP (61% versus 67%) and subsequent objective CPAP usage (mean 4.7 (2.4) versus 5.0 (2.4) hours/night) were not different. CONCLUSIONS: Use of home sleep studies has benefits in time and cost. For diagnostic reliability a further sleep study was required in 56% of cases.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• McNicholas, W. T. (2008). Diagnosis of Obstructive Sleep Apnea in Adults. Proc Am Thorac Soc 5: 154-160 [Abstract] [Full Text]  
• Ahmed, M., Patel, N. P., Rosen, I. (2007). Portable Monitors in the Diagnosis of Obstructive Sleep Apnea. Chest 132: 1672-1677 [Abstract] [Full Text]  
• Riha, R. L., Brander, P., Vennelle, M., McArdle, N., Kerr, S. M., Anderson, N. H., Douglas, N. J. (2005). Tumour necrosis factor-{alpha} (-308) gene polymorphism in obstructive sleep apnoea-hypopnoea syndrome. Eur Respir J 26: 673-678 [Abstract] [Full Text]  
• Westbrook, P. R., Levendowski, D. J., Cvetinovic, M., Zavora, T., Velimirovic, V., Henninger, D., Nicholson, D. (2005). Description and Validation of the Apnea Risk Evaluation System: A Novel Method To Diagnose Sleep Apnea-Hypopnea in the Home. Chest 128: 2166-2175 [Abstract] [Full Text]  
• Hukins, C. A. (2005). Arbitrary-Pressure Continuous Positive Airway Pressure for Obstructive Sleep Apnea Syndrome. Am. J. Respir. Crit. Care Med. 171: 500-505 [Abstract] [Full Text]  
• Fietze, I., Dingli, K., Diefenbach, K., Douglas, N.J., Glos, M., Tallafuss, M., Terhalle, W., Witt, C. (2004). Night-to-night variation of the oxygen desaturation index in sleep apnoea syndrome. Eur Respir J 24: 987-993 [Abstract] [Full Text]  
• Coughlin, S. R, Mawdsley, L., Mugarza, J. A, Calverley, P. M.A, Wilding, J. P.H (2004). Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J 25: 735-741 [Abstract] [Full Text]  
• Johnson, M K, Carter, R, Nicol, A, Paton, R, Banham, S W (2004). Long-term continuous positive airway pressure (CPAP) outcomes from a sleep service using limited sleep studies and daycase CPAP titration in the management of obstructive sleep apnoea/hypopnoea syndrome. Chronic Respiratory Disease 1: 83-88 [Abstract]  
• Schlosshan, D, Elliott, M W (2004). Sleep * 3: Clinical presentation and diagnosis of the obstructive sleep apnoea hypopnoea syndrome. Thorax 59: 347-352 [Abstract] [Full Text]  
• Udwadia, Z. F., Doshi, A. V., Lonkar, S. G., Singh, C. I. (2004). Prevalence of Sleep-disordered Breathing and Sleep Apnea in Middle-aged Urban Indian Men. Am. J. Respir. Crit. Care Med. 169: 168-173 [Abstract] [Full Text]  
• Flemons, W. W., Littner, M. R., Rowley, J. A., Gay, P., Anderson, W. M., Hudgel, D. W., McEvoy, R. D., Loube, D. I. (2003). Home Diagnosis of Sleep Apnea: A Systematic Review of the Literature: An Evidence Review Cosponsored by the American Academy of Sleep Medicine, the American College of Chest Physicians, and the American Thoracic Society. Chest 124: 1543-1579 [Full Text]  
• Bar, A., Pillar, G., Dvir, I., Sheffy, J., Schnall, R. P., Lavie, P. (2003). Evaluation of a Portable Device Based on Peripheral Arterial Tone for Unattended Home Sleep Studies. Chest 123: 695-703 [Abstract] [Full Text]  
• Dingli, K., Coleman, E.L., Vennelle, M., Finch, S.P., Wraith, P.K., Mackay, T.W., Douglas, N.J. (2003). Evaluation of a portable device for diagnosing the sleep apnoea/hypopnoea syndrome. Eur Respir J 21: 253-259 [Abstract] [Full Text]  
• Golpe, R., Jimenez, A., Carpizo, R. (2002). Home Sleep Studies in the Assessment of Sleep Apnea/Hypopnea Syndrome. Chest 122: 1156-1161 [Abstract] [Full Text]  
• Reuveni, H., Schweitzer, E., Tarasiuk, A. (2001). A Cost-Effectiveness Analysis of Alternative At-Home or In-Laboratory Technologies for the Diagnosis of Obstructive Sleep Apnea Syndrome. Med Decis Making 21: 451-458 [Abstract]  
• Lloberes, P., Sampol, G., Levy, G., Aristizabal, D., Sagales, T., De la Calzada, M., Roca, A., Canas, I., Morell, F. (2001). Influence of setting on unattended respiratory monitoring in the sleep apnoea/hypopnoea syndrome. Eur Respir J 18: 530-534 [Abstract] [Full Text]  
• Brijker, F., van den Elshout, F. J. J., Heijdra, Y. F., Folgering, H. Th. M. (2001). Underestimation of Nocturnal Hypoxemia Due to Monitoring Conditions in Patients With COPD. Chest 119: 1820-1826 [Abstract] [Full Text]  
• DOUGLAS, N. J. (2001). "Why am I sleepy?" . Sorting the Somnolent. Am. J. Respir. Crit. Care Med. 163: 1310-1313 [Full Text]  
• d'Ortho, M.-P., Grillier-Lanoir, V., Levy, P., Goldenberg, F., Corriger, E., Harf, A., Lofaso, F. (2000). Constant vs Automatic Continuous Positive Airway Pressure Therapy : Home Evaluation. Chest 118: 1010-1017 [Abstract] [Full Text]  
• PORTIER, F., PORTMANN, A., CZERNICHOW, P., VASCAUT, L., DEVIN, E., BENHAMOU, D., CUVELIER, A., MUIR, J. F. (2000). Evaluation of Home versus Laboratory Polysomnography in the Diagnosis of Sleep Apnea Syndrome. Am. J. Respir. Crit. Care Med. 162: 814-818 [Abstract] [Full Text]