Are at-home sleep studies performed using portable monitors (PMs) as effective at diagnosing obstructive sleep apnea (OSA) in adults as sleep laboratory-based polysomnography (PSG)?

UNLABELLED

RESIDENCY PROGRAM: University of Oklahoma Health Sciences Center, Department of Family and Preventive Medicine, Oklahoma City, OK.

ANSWER

In patients with suspected OSA, it is reasonable to use PMs if the patient has a high pretest probability (based on an Epworth Sleepiness Scale (ESS) ≥10 and clinical symptoms*) without significant co-morbid heart disease or other sleep disorders and he/she is able to prove competency in setting up the home equipment properly without assistance. However, if the patient has a negative PM, it is standard to perform PSG as it appears approximately 20% will have a false negative PM. (*Clinical symptoms include snoring, witnessed apneas, obesity, pulmonary hypertension, refractory hypertension, morning headaches, increased neck circumference-->17 inches in men, >16 inches in women--daytime sleepiness.) LEVEL OF EVIDENCE FOR THE ANSWER: A. SEARCH TERMS: obstructive sleep apnea, polysomnography, portable home monitors, efficacy.

INCLUSION CRITERIA

polysomnography, ambulatory, adults, humans. ESCLUSION CRITERIA: children.