Predictors of Obstructive Sleep Apnea on Polysomnography after a Technically Inadequate or Normal Home Sleep Test
Open accessAbstract
Study objectives Home sleep testing (HST) is an accepted alternative to polysomnography (PSG) for diagnosing obstructive sleep apnea (OSA) in high-risk populations. Clinical guidelines recommend PSG in cases where the HST is technically inadequate (TI) or fails to establish the diagnosis of OSA in patients with high pretest probability. This retrospective study evaluated predictors of OSA on PSG within patients who had a TI or normal HST.Methods Electronic medical records were reviewed on 1,157 patients referred for HST at our sleep center. Two hundred thirty-eight patients had a TI or normal HST with subsequent PSG. Age, BMI, Epworth score, HST result, and PSG-based apnea-hypopnea index (AHI) were abstracted.Results Two hundred thirty-eight consecutive patients with either a normal HST (n = 127) or TI HST (n = 111) underwent subsequent PSG. Of 127 who had a normal HST, 76% had a normal PSG and 24% had OSA (23 mild, 6 moderate, 1 severe). Of 111 who had a TI HST, 29% had a normal PSG and 71% had OSA (43 mild, 19 moderate, 17 severe). Individuals younger than 50 years old with a normal HST were more likely to have a normal PSG. Older age predicted diagnosis of OSA on PSG among individuals with a TI HST.Conclusion In this retrospective analysis of a clinical sample, when the HST is interpreted as normal in a younger patient population, the subsequent PSG is likewise normal in majority of the patients, although significant OSA is sometimes discovered. When a HST is read as TI, the majority of patients have OSA.
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Among high pretest probability patients with a technically inadequate HSAT who later had PSG, OSA was found in 71%.
“found OSA in 71% of the patients with technically inadequate studies”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [615]
Older age and lower ESS were associated with OSA on subsequent PSG after an inadequate or normal HSAT.
“Older age and lower ESS were associated with OSA on the subsequent PSG.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [615]
Among high pretest probability patients with a normal HSAT who later had PSG, OSA was found in 24%.
“and 24% of the patients with normal HSATs.615”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [615]
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- Authors
- Zeidler, M. R., Santiago, V., Dzierzewski, J. M., Mitchell, M. N., Santiago, S., & Martin, J. L.
- Affiliations
- University of California, Los Angeles (US)
- University of California, San Francisco (US)
- VA Greater Los Angeles Healthcare System (US)
- Corresponding author
- Zeidler, Michelle R.
- Venue
- Journal of Clinical Sleep Medicine
- Published
- 2015-11-15
- Volume
- 11
- Issue
- 11
- Pages
- 1313-1318
- ISSN
- 1550-9389 (ISSN-L)
- 1550-9397
- PMC
- PMC4623130
- OpenAlex
- W2415683138
- Semantic Scholar
- e5014459e7e859745e214cdfa675501412ca9447
- Cited by
- 35
- References
- 17
- Citations by year
- 2026: 3 · 2025: 4 · 2023: 5 · 2022: 4 · 2021: 2 · 2020: 7 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 1
- FWCI
- 1.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Sleep Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (UL1TR000124)
- National Institute on Aging (P30AG028748)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- obstructive sleep apnea, home sleep testing, polysomnography, OSA diagnosis, apnea-hypopnea index, age as predictor, body mass index, Epworth Sleepiness Scale, diagnostic yield
- MeSH terms
- Female, Humans, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Severity of Illness Index, Polysomnography, Sleep Apnea, Obstructive
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