Zhonghua Jie He He Hu Xi Za Zhi. 2022 Feb 12;45(2):133-142. doi: 10.3760/cma.j.cn112147-20211029-00751.
With the advancement of home sleep apnea test (HSAT) technology and the increase of encouraging evidence of home-based management approach for obstructive sleep apnea (OSA), HSAT devices using different types of biosignal acquisition technology are more and more widely used for the diagnosis of OSA in adults. HSAT for the diagnosis of OSA should be performed in combination with a comprehensive clinical and sleep evaluation. HSAT can be used as a diagnostic tool for uncomplicated OSA with a high pretest probability of moderate to severe OSA. A negative HSAT result cannot exclude the diagnosis of OSA for subjects with high clinical suspicion. Polysomnography (PSG) is preferred for the diagnosis of OSA in patients with significant comorbid medical conditions. The clinical application of HSAT in the diagnosis of complicated OSA needs to refer to the severity of clinical condition, comorbid disease, personal preference, local medical insurance policy and the accessibility of medical resources. HSAT may be indicated for the diagnosis of OSA in patients for whom attended PSG is not possible by virtue of immobility, safety, or critical illness. HSAT can be used for the screening of OSA in subjects with cardiocerebrovascular diseases. Follow-up HSAT or PSG is recommended to evaluate therapeutic response with non-positive airway pressure (PAP) interventions. Follow-up HSAT or PSG can be used for reassessment for patients with clinically significant weight fluctuation, persistent or recurrent symptoms under good PAP adherence, emergence or changes in cardiovascular diseases. Due to limitations of current automatic scoring algorithms that restrict the diagnostic accuracy, it is mandatory to review the raw data of type 3 devices. The selection of HSAT equipment, interpretation of monitoring results and the development of management plan should be under the guidance of physicians with sleep medicine training. Consumer-grade technologies are not appropriate for the clinical diagnosis of OSA due to lack of validation.
随着家庭睡眠呼吸暂停测试（HSAT）技术的进步以及阻塞性睡眠呼吸暂停（OSA）家庭管理方法的支持证据不断增加，采用不同类型生物信号采集技术的HSAT设备越来越广泛地用于成人OSA的诊断。用于OSA诊断的HSAT应结合全面的临床和睡眠评估进行。HSAT可作为中度至重度OSA预测试概率较高的单纯性OSA的诊断工具。HSAT结果为阴性不能排除临床高度怀疑患者的OSA诊断。对于有严重合并症的患者，多导睡眠图（PSG）是OSA诊断的首选方法。HSAT在复杂OSA诊断中的临床应用需要参考临床病情严重程度、合并疾病、个人偏好、当地医疗保险政策以及医疗资源的可及性。对于因行动不便、安全问题或危重症而无法进行PSG检查的患者，HSAT可能适用于OSA的诊断。HSAT可用于筛查心脑血管疾病患者的OSA。建议采用非正压通气（PAP）干预措施后进行HSAT或PSG随访以评估治疗反应。对于临床体重波动明显、在良好的PAP依从性下仍有持续或复发症状、出现心血管疾病或心血管疾病发生变化的患者，可采用HSAT或PSG随访进行重新评估。由于目前自动评分算法的局限性限制了诊断准确性，因此必须审查3型设备的原始数据。HSAT设备的选择、监测结果的解读以及管理计划的制定应在接受睡眠医学培训的医生指导下进行。由于缺乏验证，消费级技术不适用于OSA的临床诊断。
