Lechat Bastien, Scott Hannah, Manners Jack, Adams Robert, Proctor Simon, Mukherjee Sutapa, Catcheside Peter, Eckert Danny J, Vakulin Andrew, Reynolds Amy C
Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia.
Flinders Health and Medical Research Institute/Adelaide Institute for Sleep Health, Flinders University, Australia.
Sleep Med Rev. 2023 Dec;72:101843. doi: 10.1016/j.smrv.2023.101843. Epub 2023 Sep 1.
Substantial night-to-night variability in obstructive sleep apnoea (OSA) severity has raised misdiagnosis and misdirected treatment concerns with the current prevailing single-night diagnostic approach. In-home, multi-night sleep monitoring technology may provide a feasible complimentary diagnostic pathway to improve both the speed and accuracy of OSA diagnosis and monitor treatment efficacy. This review describes the latest evidence on night-to-night variability in OSA severity, and its impact on OSA diagnostic misclassification. Emerging evidence for the potential impact of night-to-night variability in OSA severity to influence important health risk outcomes associated with OSA is considered. This review also characterises emerging diagnostic applications of wearable and non-wearable technologies that may provide an alternative, or complimentary, approach to traditional OSA diagnostic pathways. The required evidence to translate these devices into clinical care is also discussed. Appropriately sized randomised controlled trials are needed to determine the most appropriate and effective technologies for OSA diagnosis, as well as the optimal number of nights needed for accurate diagnosis and management. Potential risks versus benefits, patient perspectives, and cost-effectiveness of these novel approaches should be carefully considered in future trials.
阻塞性睡眠呼吸暂停（OSA）严重程度在夜间存在显著差异，这引发了人们对当前普遍采用的单夜诊断方法可能导致误诊和治疗方向错误的担忧。家庭多夜睡眠监测技术或许能提供一种可行的辅助诊断途径，以提高OSA诊断的速度和准确性，并监测治疗效果。本综述阐述了关于OSA严重程度夜间差异的最新证据，及其对OSA诊断错误分类的影响。文中还探讨了OSA严重程度夜间差异可能影响与OSA相关的重要健康风险结果的新证据。本综述还介绍了可穿戴和不可穿戴技术新兴的诊断应用，这些技术可能为传统OSA诊断途径提供替代或补充方法。文中还讨论了将这些设备应用于临床护理所需的证据。需要进行适当规模的随机对照试验，以确定用于OSA诊断的最合适、最有效的技术，以及准确诊断和管理所需的最佳夜间监测次数。在未来的试验中，应仔细考虑这些新方法的潜在风险与益处、患者观点以及成本效益。
