Source: Annual Congress 2002 - Airway obstruction measurement (FOT - NEP) sleep and lung sound analysis
Disease area: Sleep and breathing disorders

Abstract

Background: Waiting times for hospital-based monitoring of sleep-related breathing disorders are rising. We therefore tested the hypothesis that a new portable device (Embletta, Flagahf) may in many patients diagnose Obstructive Sleep Apnoea/Hypopnoea (OSAH) at home and replace in-lab polysomnography.
Methods: Two studies were performed: a synchronous comparison to diagnostic polysomnography in 40 patients and a prospective trial on 50 patients, comparing home Embletta studies with in-laboratory polysomnography.
Results: In the synchronous study the mean difference [polysomnography-Embletta] in apnoeas+hypopnoeas (A+H)/hr-in-bed was 2SD5/hr (p=0.02;rho=0.98,p<0.001). In comparison to the AHI/hr slept the Embletta A+H/hr-in-bed differed by a mean of 8SD16/hr. These data were used to construct following diagnostic categories in symptomatic patients from their Embletta results: [dsquote]OSAHS[dsquote] (>20 A+H/hr-in-bed), [dsquote]possible OSAHS[dsquote] (10-20 A+H/hr-in-bed) or [dsquote]not OSAHS[dsquote] (<10 A+H/hr-in-bed). In the home study the mean difference in A+H/hr-in-bed was 3SD13/hr (p=0.06;rho=0.74,p<0.001). In comparison to the polysomnographic AHI/hr-slept, the Embletta A+H/hr-in-bed differed by a mean of 6±]14/hr (p=0.006). Using the above diagnostic classification, all 9 patients with [dsquote]not OSAHS[dsquote] had an AHI<15/hr slept (median 9/hr, range 4-14/hr) on polysomnography and all 23 with [dsquote]OSAHS[dsquote] on Embletta had an AHI>15 on polysomnography, but 18 patients fell into the [dsquote]possible OSAHS[dsquote] category potentially requiring further investigation.
Conclusions: Most patients were satisfactorily classified by a home limited sleep study. 18/50 required further investigation. The study suggested a 48% saving in diagnostic costs if this approach were adopted rather than polysomnography.

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Citations should be made in the following way:
K. Dingli, M. Vennelle, P. K. Wraith, T. W. MacKay, N. J. Douglas (Edinburgh, United Kingdom). Home-based monitoring versus in-lab polysomnography in diagnosing the sleep apnoea/hypopnoea syndrome. Eur Respir J 2002; 20: Suppl. 38, 322

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