Chest Department, Taipei Veterans General Hospital, Taipei Institute of Clinical Medicine Faculty of Medicine, School of Medicine Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan.
Respirology. 2011 Oct;16(7):1096-102. doi: 10.1111/j.1440-1843.2011.02022.x.
To combine the diagnosis of OSA with titration of positive airway pressure (PAP), current guidelines recommend that split-night polysomnography (PSG) be performed if an AHI of ≥40/h is recorded over 2h. However, the diagnostic validity of partial-night PSG is uncertain. This study aimed to test the validity of partial-night PSG and to determine the optimum AHI cut-off points.
Patients who visited the sleep centre at a tertiary medical centre between January and December 2008, for symptoms related to sleep disorders (sleepiness, snoring, sleep disturbance), and who completed full-night PSG, were evaluated for this study. Full-night PSG data were processed to obtain partial-night PSG data, from which AHI were computed as a reference for diagnosing severe OSA. Full-night and partial-night PSG data obtained over different recording times (expressed as x-h PSG, where xONL001831140 =1-6) were compared using receiver operating characteristic (ROC) curve analysis. The diagnostic validity of 2-h PSG with different AHI cut-off points (25/h to 45/h) was also calculated.
Data from 198 PSG recordings was processed. For 2-h PSG, an AHI cut-off point of 30/h gave the highest accuracy of 90.9%. Comparing areas under the ROC curves (AUC), 2-h PSG (AUC=0.97) was as good as 2.5-h PSG (AUC=0.977, P=0.057) and 3-h PSG (AUC=0.978, P=0.125), but was better than 1.5-h PSG (AUC=0.955, P=0.016).
Partial-night PSG is effective for diagnosing severe OSA. If there is an unabridged PSG recording indicating an AHI of ≥30/h for 2h, severe OSA can be diagnosed and PAP titration initiated.
为了将 OSA 的诊断与正压气道通气（PAP）滴定相结合，如果在 2 小时内记录到的 AHI 大于等于 40/h，则当前指南建议进行分夜多导睡眠图（PSG）。然而，部分夜间 PSG 的诊断有效性尚不确定。本研究旨在测试部分夜间 PSG 的有效性，并确定最佳 AHI 截止点。
本研究评估了 2008 年 1 月至 12 月期间在一家三级医疗中心睡眠中心就诊的患者，这些患者因与睡眠障碍相关的症状（嗜睡、打鼾、睡眠障碍）而就诊，并完成了整夜 PSG。整夜 PSG 数据经过处理，以获得部分夜间 PSG 数据，该数据被计算为诊断严重 OSA 的参考。使用接收者操作特征（ROC）曲线分析比较不同记录时间（表示为 x-h PSG，其中 xONL001831140=1-6）的全夜和部分夜间 PSG 数据。还计算了不同 AHI 截止点（25/h 至 45/h）的 2 小时 PSG 的诊断有效性。
处理了 198 次 PSG 记录的数据。对于 2 小时 PSG，AHI 截止点为 30/h 时准确性最高，为 90.9%。比较 ROC 曲线下的面积（AUC），2 小时 PSG（AUC=0.97）与 2.5 小时 PSG（AUC=0.977，P=0.057）和 3 小时 PSG（AUC=0.978，P=0.125）一样好，但优于 1.5 小时 PSG（AUC=0.955，P=0.016）。
部分夜间 PSG 可有效诊断严重 OSA。如果有完整的 PSG 记录表明 2 小时内 AHI 大于等于 30/h，则可以诊断为严重 OSA 并开始进行 PAP 滴定。
