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Original article
Effectiveness of home respiratory polygraphy for the diagnosis of sleep apnoea and hypopnoea syndrome
  1. Juan F Masa1,2,
  2. Jaime Corral1,2,
  3. Ricardo Pereira1,2,
  4. Joaquin Duran-Cantolla2,3,
  5. Marta Cabello4,
  6. Luis Hernández-Blasco5,
  7. Carmen Monasterio6,
  8. Alberto Alonso2,7,
  9. Eusebi Chiner8,
  10. Manuela Rubio1,
  11. Estefania Garcia-Ledesma1,
  12. Laura Cacelo3,
  13. Rosario Carpizo4,
  14. Lirios Sacristan5,
  15. Neus Salord6,
  16. Miguel Carrera7,
  17. José N Sancho-Chust8,
  18. Cristina Embid9,
  19. Francisco-José Vázquez-Polo10,
  20. Miguel A Negrín10,
  21. Jose M Montserrat2,9
  1. 1Pulmonary Service, San Pedro de Alcantara Hospital, Caceres, Spain
  2. 2CIBER de enfermedades respiratorias (CIBERES), Madrid, Spain
  3. 3Pulmonary Service, Txagoritxu Hospital, Vitoria, Spain
  4. 4Pulmonary Service, Valdecilla Hospital, Santander, Spain
  5. 5Pulmonary Service, General Universitario Hospital, Alicante, Spain
  6. 6Pulmonary Service, Belvitge Hospital, Barcelona, Spain
  7. 7Pulmonary Service, Son Dureta Hospital, Palma de Mallorca, Spain
  8. 8Pulmonary Service, San Juan Hospital, Alicante, Spain
  9. 9Pulmonary Service, Clinic Hospital, Barcelona, Spain
  10. 10Department of Quantitative Methods, Las Palmas de Gran Canaria University, Spain
  1. Correspondence to Dr Juan F Masa, San Pedro de Alcántara Hospital, Pablo Naranjo s/n, Cáceres 10003, Spain; fmasa{at}


Introduction Home respiratory polygraphy (HRP) may be a cost-effective alternative to polysomnography for the diagnosis of sleep apnoea-hypopnoea syndrome (SAHS), but stronger evidence is needed. Normally, patients transport HRP equipment from the hospital to home and back, which may create difficulties for some patients.

Objectives To determine both the diagnostic efficacy and cost of HRP (with and without a transportation service moving the device and telematic transmission of data) in a large sample compared with in-hospital polysomnography.

Methods Patients suspected of having SAHS were included in a multicentre study (eight hospitals). They were assigned to home and hospital protocols in random order. Receiver operating characteristic curves were constructed for manual respiratory polygraphy scoring protocol and different polysomnographic cut-off points. Diagnostic efficacies for several polysomnographic cut-off points were explored and costs for two equally effective alternatives were calculated.

Results Of 366 randomised patients, 348 completed the protocol. The best receiver operating characteristic curve was obtained with a polysomnographic cut-off of the apnoea-hypopnoea index (AHI)≥5. The sensitive HRP AHI cut-off point (<5) had a sensitivity of 96%, a specificity of 57% and a negative likelihood ratio (LR) of 0.07; the specific cut-off (>10) had a sensitivity of 87%, a specificity of 86% and a positive LR of 6.25. The cost of HRP was half that of polysomnography. Telematic transmission costs were similar if the patients' costs were taken in to account.

Conclusion HRP is an alternative to polysomnography in patients with suspected SAHS. Telematic procedures may help patients with limited mobility and those who live a long way from the sleep centre.

  • Sleep apnoea
  • portable monitor
  • respiratory polygraphy
  • telemedicine

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  • Funding Instituto de Salud Carlos III (Fondo de Investigaciones Sanitarias, Ministerio de Sanidad y Consumo), Spanish Respiratory Society (SEPAR), Telefonica SA (Spain), Air Liquide (Spain) and Breas Medical (Spain). We are grateful for the support of project ECO2009-14152 (Ministerio de Ciencia e Innovación).

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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