Ghegan Mark D, Angelos Patrick C, Stonebraker Angela C, Gillespie M Boyd
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Laryngoscope. 2006 Jun;116(6):859-64. doi: 10.1097/01.mlg.0000214866.32050.2e.
The objective of this meta-analysis study was to compare the accuracy of home sleep studies with laboratory polysomnography in the diagnosis of obstructive sleep apnea (OSA).
Eligible studies included prospective cohort studies of portable and in-laboratory sleep studies performed on the same groups of patients. A comparison of respiratory disturbance index (RDI), mean low oxygen saturation levels, sleep time, rate of inadequate studies, and average cost per examination was made between portable and in-laboratory sleep studies. A total of 18 papers were identified in two independent Medline searches.
RDI values on portable sleep studies were 10% lower on average compared with laboratory studies (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.87-0.92). There was no significant difference in the mean low oxygen saturation on portable versus laboratory studies (OR, 1.0; 95% CI, 0.94-1.10). Recorded sleep time was significantly higher by 13% for laboratory compared with portable studies (OR, 0.87; 95% CI, 0.86-0.89), and portable studies were significantly more likely to give a poor recording when compared with laboratory examinations (P = .0001). The cost of home studies ranged from 35% to 88% lower than laboratory studies across a number of countries.
Home sleep studies provide similar diagnostic information to laboratory polysomnograms in the evaluation of sleep-disordered breathing but may underestimate sleep apnea severity. The lower cost of home sleep studies makes it a viable screening tool for patients with suspected OSA; however, these lower costs are partially offset by the higher rate of inadequate examinations.
本荟萃分析研究的目的是比较家庭睡眠监测与实验室多导睡眠图在阻塞性睡眠呼吸暂停（OSA）诊断中的准确性。
符合条件的研究包括对同一组患者进行的便携式和实验室睡眠监测的前瞻性队列研究。比较了便携式和实验室睡眠监测之间的呼吸紊乱指数（RDI）、平均低氧饱和度水平、睡眠时间、研究不充分率以及每次检查的平均成本。在两次独立的Medline检索中总共识别出18篇论文。
便携式睡眠监测的RDI值平均比实验室研究低10%（优势比[OR]，0.90；95%置信区间[CI]，0.87 - 0.92）。便携式与实验室研究的平均低氧饱和度无显著差异（OR，1.0；95% CI，0.94 - 1.10）。与便携式研究相比，实验室记录的睡眠时间显著高出13%（OR，0.87；95% CI，0.86 - 0.89），并且与实验室检查相比，便携式研究更有可能记录不佳（P = 0.0001）。在多个国家，家庭监测的成本比实验室研究低35%至88%。
家庭睡眠监测在评估睡眠呼吸障碍方面提供了与实验室多导睡眠图类似的诊断信息，但可能低估睡眠呼吸暂停的严重程度。家庭睡眠监测较低的成本使其成为疑似OSA患者可行的筛查工具；然而，这些较低的成本部分被较高的检查不充分率所抵消。
