量化家庭睡眠呼吸暂停检测中总记录时间与总睡眠时间之间差异的来源：基于家庭多导睡眠图的见解。

Quantifying the sources of discrepancy between total recording time and total sleep time in home sleep apnea testing: insights from home-based polysomnography.

作者信息

Nikolopoulos Apostolis, Tatsis Konstantinos, Tselepi Charikleia, Sioutkou Agni, Kostoulas Athanasios, Siopis Georgios, Kostikas Konstantinos, Konstantinidis Athanasios

机构信息

Sleep Disorders Unit, Department of Respiratory Medicine, University Hospital of Ioannina, Ioannina, Greece.

Department of Respiratory Medicine, University Hospital of Ioannina, Ioannina, Greece.

出版信息

J Clin Sleep Med. 2025 Jun 1;21(6):1065-1072. doi: 10.5664/jcsm.11632.

DOI:10.5664/jcsm.11632

PMID:40078095

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12134572/

Abstract

STUDY OBJECTIVES

To quantify the contribution of sleep onset latency (SOL), wake after sleep onset (WASO), and wake after sleep offset (WASF) to the discrepancy between total recording time (TRT) and total sleep time (TST) in home-based polysomnography (PSG) using patient-activated and deactivated monitoring devices.

METHODS

This observational study enrolled patients with a high pretest probability of obstructive sleep apnea who underwent unattended home-based PSG. We measured the duration of SOL, WASO, and WASF to quantify the discrepancy between TRT and TST. TRT was defined as the interval from device activation to deactivation by the patients. SOL represented the time from device activation to the first epoch of any sleep, WASO was the total amount of time spent awake after the sleep onset epoch until the last epoch of any sleep, and WASF was defined as the time from the last epoch of any sleep until the patient-initiated device deactivation. We also assessed differences in the apnea-hypopnea index between home-based PSG and type 3 sleep studies by reanalyzing home-based PSG recordings as simulated type 3 studies after omitting type 2 signals.

RESULTS

A total of 78 patients were included in the study. The mean TRT exceeded the mean TST by 19%, with TRT at 457 ± 78 minutes and TST at 383 ± 68 minutes. The mean difference between TRT and TST was 74 ± 53 minutes, attributed to SOL (30%), WASO (45%), and WASF (25%). There was considerable variability in the difference between TRT and TST among study participants, ranging from as little as 14 minutes to as much as 233 minutes. The mean apnea-hypopnea index in simulated type 3 studies (41 ± 29 events/h) was, on average, 23% lower than the mean apnea-hypopnea index recorded in home-based PSG (53 ± 30 events/h) ( < .001).

CONCLUSIONS

There was significant variability in the gap between TRT and TST among patients at increased risk of obstructive sleep apnea undergoing unattended home-based PSG. WASO was identified as the largest contributor to this discrepancy, with notable contributions from SOL and WASF. Additionally, simulated type 3 studies underestimated the true apnea-hypopnea index compared to type 2 studies.

CITATION

Nikolopoulos A, Tatsis K, Tselepi C, et al. Quantifying the sources of discrepancy between total recording time and total sleep time in home sleep apnea testing: insights from home-based polysomnography. . 2025;21(6):1065-1072.

摘要

研究目的

使用患者激活和停用的监测设备，量化睡眠起始潜伏期（SOL）、睡眠中觉醒时间（WASO）和睡眠结束后觉醒时间（WASF）对家庭多导睡眠图（PSG）中总记录时间（TRT）和总睡眠时间（TST）差异的贡献。

方法

这项观察性研究纳入了阻塞性睡眠呼吸暂停预测试概率较高且接受无人值守家庭PSG检查的患者。我们测量了SOL、WASO和WASF的持续时间，以量化TRT和TST之间的差异。TRT定义为从设备激活到患者停用的时间间隔。SOL表示从设备激活到首次出现任何睡眠阶段的时间，WASO是指从睡眠起始阶段到任何睡眠的最后一个阶段之间醒来所花费的总时间，WASF定义为从任何睡眠的最后一个阶段到患者主动停用设备的时间。我们还通过在省略2型信号后将家庭PSG记录重新分析为模拟3型研究，评估了家庭PSG和3型睡眠研究之间呼吸暂停低通气指数的差异。

结果

共有78名患者纳入研究。平均TRT比平均TST长19%，TRT为457±78分钟，TST为383±68分钟。TRT和TST之间的平均差异为74±53分钟，这归因于SOL（30%）、WASO（45%）和WASF（25%）。研究参与者中TRT和TST之间的差异存在很大变异性，范围从低至14分钟到高达233分钟。模拟3型研究中的平均呼吸暂停低通气指数（41±29次/小时）平均比家庭PSG记录中的平均呼吸暂停低通气指数（53±30次/小时）低23%（P<0.001）。