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Sleep Med Rev. 2014 Aug;18(4):341-7. doi: 10.1016/j.smrv.2013.12.002. Epub 2013 Dec 12.

Unattended home-based polysomnography for sleep disordered breathing: current concepts and perspectives.

Author information

1
Chest Service, Saint-Pierre University Hospital, Rue Haute, 322, 1000 Brussels, Belgium. Electronic address: Marie_Bruyneel@stpierre-bru.be.
2
Chest Service, Saint-Pierre University Hospital, Rue Haute, 322, 1000 Brussels, Belgium.

Abstract

Recently, portable sleep recording devices became an accepted alternative to polysomnography (PSG) for obstructive sleep apnea (OSA) diagnosis in patients with a high pre-test probability of moderate to severe OSA but home polysomnography (H-PSG) was not recommended because there were insufficient data. The present review has analysed six prospective randomized crossover studies comparing H-PSG to in-lab PSG. These studies convincingly showed that H-PSG allows complete sleep evaluation. The quality of patients' sleep tends to be better at home. H-PSG is accurate for OSA diagnosis and the failure rate is low despite the absence of supervision. In addition, it could offer a final and comprehensive diagnosis for many other sleep disorders. It is also likely that H-PSG can reduce PSG-related costs but complete cost-effectiveness analyses are not yet available. Recently, remotely attended H-PSG via telemonitoring has been tested and may reduce H-PSG failure rate. In conclusion, H-PSG can be used to rule-in and rule out OSA in suspected patients, even in the presence of co-morbidities and is an alternative when simplified sleep testing is negative. Future developments should target simplification of technical aspects of H-PSG, together with remote monitoring, in order to obtain good quality H-PSG performed in adequate conditions.

KEYWORDS:

Home unattended polysomnography; Obstructive sleep apnea; Sleep disorders; Sleep quality; Telemedicine

PMID:
24388970
DOI:
10.1016/j.smrv.2013.12.002
[Indexed for MEDLINE]

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