First-night-effect on polysomnographic respiratory sleep parameters in patients with sleep-disordered breathing and upper airway pathology
Abstract
The objective of this study is to test whether there is a difference between the polysomnographic (PSG) values of Apnea-hypopnea index (AHI), minimal oxygen saturation (SpO(2)), oxygen desaturation index (ODI) and arousal index recorded on two consecutive nights (so-called "first night effect") in patients with sleep-disordered breathing (SDB) and concomitant upper airway pathology. Retrospective case-control study of polysomnographical recordings of 130 patients (112 males, 18 females, age range 23-80 years) with SDB and upper airway pathology who were tested on two consecutive nights in a hospital sleep laboratory was conducted. Only patients with upper airway pathology without other medical conditions causing SDB were included. AHI, minimal SpO(2), ODI and arousal index values of the first night were compared to those of the second night using Wilcoxon's test. There were no significant statistical differences between AHI, SpO(2), ODI and arousal index values (P = 0.130, P = 0.640, P = 0.052, and P = 0.692, respectively) between the two nights. However, 15% of the patients showed significant variability in the AHI between the two recordings and in 6% of the patients, a diagnosis of severe OSA (AHI > 10/h) would have been missed if only one night of sleep study had been performed. In general, one night of sleep study is sufficient to lead to a clear diagnosis of severe OSA in patients with sleep-disordered breathing and upper airway pathology but may still not diagnose 6% of…
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Our literature search identified four observational studies that compared AHI scores between two consecutive nights of PSG.
“Our literature search identified four observational studies that compared AHI scores between two consecutive nights of PSG.34,129–131”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [129]
A meta-analysis of four studies compared AHI data between 2 consecutive nights of PSG and found the mean difference in the AHI between the 2 nights was 0.14 (95% CI: −1.86 to 2.15), which was not statistically or clinically significant.
“A meta-analysis of four studies compared AHI data between 2 consecutive nights of PSG34,129–131 (see supplemental material, Figure S28 and Table S66) and found the mean difference in the AHI between the 2 nights was 0.14 (95% CI: −1.86 to 2.15), which was not statistically or clinically significant.”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [129]
The overall quality of evidence for comparing night-to-night AHI variability was originally considered high, due to precise and consistent data across studies.
“The overall quality of evidence for comparing night-to-night AHI variability was originally considered high, due to precise and consistent data across studies.34,129–131”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [129]
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- Authors
- Gouveris, H., Selivanova, O., Bausmer, U., Goepel, B., & Mann, W.
- Affiliations
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- Corresponding author
- Gouveris, Haralampos
- Venue
- European Archives of Oto-Rhino-Laryngology
- Published
- 2010-02-02
- Volume
- 267
- Issue
- 9
- Pages
- 1449-1453
- ISSN
- 0937-4477 (ISSN-L)
- 1434-4726
- OpenAlex
- W2015834332
- Cited by
- 59
- References
- 0
- Citations by year
- 2026: 2 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 7 · 2020: 5 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 5 · 2015: 4 · 2014: 2 · 2013: 6 · 2012: 5
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Archives of Oto-Rhino-Laryngology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Keywords
- first-night effect, sleep-disordered breathing, obstructive sleep apnea, apnea-hypopnea index, oxygen desaturation index, arousal index, oxygen saturation, polysomnography, night-to-night variability
- MeSH terms
- Adult, Aged, Aged, 80 and over, Airway Obstruction, Female, Habituation, Psychophysiologic, Humans, Male, Middle Aged, Sensitivity and Specificity, Polysomnography, Statistics, Nonparametric, Sleep Apnea, Obstructive, Young Adult
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