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Utility of split-night polysomnography in the diagnosis of upper airway resistance syndrome
Abstract
Purpose Split-night polysomnography can both establish the diagnosis and titrate continuous positive airway pressure (CPAP) during a single study in patients with sleep-disordered breathing. We sought to determine if split-night polysomnography could be effectively used in upper airway resistance syndrome (UARS) without diminishing diagnostic accuracy or success of CPAP titration. Methods Consecutive patients diagnosed with UARS were included. Split-night studies were performed in patients meeting predefined criteria. We compared data between those undergoing traditional and split-night polysomnography. Results We included 100 consecutive patients (41.2 +/- 7.4 years, 54% men). Forty-six underwent split-night polysomnography. Groups were similar at baseline. There were no differences in polysomnography or success rate of CPAP titration. Among those not undergoing split-night studies, the mean time between diagnostic polysomnography and CPAP titration was 71.9 +/- 49.0 days. Conclusions Split-night polysomnography can be effectively utilized to diagnose UARS and initiate CPAP therapy. This practice can reduce the number of studies needed and obviate the inherent delay in initiating CPAP therapy.
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Three studies compared success of CPAP titration in those undergoing a split-night study against those undergoing a full-night sleep recording.
“Three studies compared success of CPAP titration in those undergoing a split-night study against those undergoing a full-night sleep recording.125,126,128”
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 [125]
One study, focused on upper airway resistance syndrome, found no difference in the success rates of CPAP titration, defined as a RERA index < 5 on the final CPAP setting.
“One study, focused on upper airway resistance syndrome, found no difference in the success rates of CPAP titration, defined as a respiratory effort-related arousal (RERA) index < 5 on the final CPAP setting.125”
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 [125]
Our literature search yielded nine studies that met inclusion criteria.
“Our literature search yielded nine studies that met inclusion criteria.112,121–128”
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 [125]
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Kapur, V. K., Auckley, D. H., Chowdhuri, S., Kuhlmann, D. C., Mehra, R., Ramar, K., & Harrod, C. G. (2017) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6506 · Cited by 3,253
Newell, J., Mairesse, O., Verbanck, P., & Neu, D. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.07.045 · Cited by 235
Metadata
- Authors
- Kristo, D. A., Shah, A. A., Lettieri, C. J., MacDermott, S. M., Andrada, T., Taylor, Y., & Eliasson, A. H.
- Affiliations
- Walter Reed National Military Medical Center (US)
- Corresponding author
- Lettieri, Christopher J.
- Venue
- Sleep and Breathing
- Published
- 2008-12-04
- Volume
- 13
- Issue
- 3
- Pages
- 271-275
- ISSN
- 1520-9512 (ISSN-L)
- 1522-1709
- OpenAlex
- W1969068200
- Cited by
- 11
- References
- 0
- Citations by year
- 2023: 3 · 2022: 2 · 2019: 1 · 2018: 1 · 2017: 1 · 2014: 1 · 2012: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Sleep And Breathing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- split-night polysomnography, upper airway resistance syndrome, CPAP titration, sleep-disordered breathing, diagnostic accuracy
- MeSH terms
- Adult, Electrocardiography, Electromyography, Female, Humans, Disorders of Excessive Somnolence, Male, Manometry, Sleep Apnea Syndromes, Sleep Stages, Time Factors, Reproducibility of Results, Polysomnography, Muscle, Skeletal, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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