Home set-up polysomnography in the assessment of suspected obstructive sleep apnea: Home polysomnography and diagnosis of OSA
Abstract
Home set-up polysomnography (PSG) has advantages over other portable monitoring devices, but remains unendorsed by professional bodies despite excellent utility in the Sleep Heart Health Study (SHHS). The study aims to determine technical reliability and diagnostic accuracy of unattended, home set-up versus attended laboratory-based PSG in patients with suspected obstructive sleep apnea (OSA). Thirty patients with suspected OSA without significant co-morbidity were recruited. After initial lab-PSG (Compumedics S series), patients underwent home set-up PSG (Compumedics Siesta) and lab-based PSG in random order. Studies were compared for study success, signal loss and likelihood ratio for OSA diagnosis [apnea-hypopnea index (AHI) >10]. Thirty subjects (mean age 49±13.8 years, body mass index 31±6.1 kg m(-2) ) completed investigations. SHHS technical acceptability criteria were met by all lab-based PSGs and 90% of home-based PSGs (93% clinically acceptable). Signal loss was higher at home (P=0.008). Sleep efficiency was similar between sites, but more preferred home-based PSG (50%). ancova revealed AHI was significantly different if initial AHI >26 per h (P=0.006), with an average underestimate of 5.1 per h at home. In technically acceptable studies the likelihood ratios to 'rule in' and 'rule out' OSA were 8.1 and 0.1, respectively. Unattended, home set-up PSG is technically reliable and achieves excellent diagnostic utility. Signal loss was higher at home but mitigated by mult…
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In two studies evaluating Type 2 HSAT devices against PSG, using an AHI ≥ 5 cutoff, accuracy in a high-risk population (assuming a prevalence of 87%) ranged from 84% to 91%.
“In two studies that evaluated the performance of Type 2 HSAT devices against PSG,67,86 when using an AHI ≥ 5 cutoff, accuracy in a high-risk population (assuming a prevalence of 87%) ranged from 84% to 91%.”
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 [86]
Using a cutoff of AHI ≥ 15, the accuracy of Type 2 HSAT devices was 88% in a high-risk group.
“Using a cutoff of AHI ≥ 15, the accuracy of these devices was 88% in a high-risk group”
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 [86]
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- Authors
- CAMPBELL, A. J., & NEILL, A. M.
- Affiliations
- University of Otago (NZ)
- Corresponding author
- CAMPBELL, ANGELA J.
- Venue
- Journal of Sleep Research
- Publisher
- Wiley
- Published
- 2011-02-15
- Volume
- 20
- Issue
- 1pt2
- Pages
- 207-213
- ISSN
- 0962-1105 (ISSN-L)
- OpenAlex
- W1638622873
- Cited by
- 94
- References
- 0
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 6 · 2023: 3 · 2022: 4 · 2021: 9 · 2020: 6 · 2019: 3 · 2018: 6 · 2017: 6 · 2016: 9 · 2015: 14 · 2014: 8 · 2013: 7 · 2012: 3
- FWCI
- 2.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Sleep Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Keywords
- obstructive sleep apnea, diagnostic accuracy, technical reliability, apnea-hypopnea index, signal loss, likelihood ratios, Sleep Heart Health Study, home sleep monitoring, sleep efficiency
- MeSH terms
- Adult, Aged, Female, Home Care Services, Humans, Male, Middle Aged, Respiratory Physiological Phenomena, Sleep, Sleep, REM, Polysomnography, Sleep Apnea, Obstructive, Young Adult, Patient Preference
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