Night-to-night variability in obstructive sleep apnea using peripheral arterial tonometry: a case for multiple night testing.

Tschopp, Samuel; Wimmer, Wilhelm; Caversaccio, Marco; Borner, Urs; Tschopp, Kurt (2021). Night-to-night variability in obstructive sleep apnea using peripheral arterial tonometry: a case for multiple night testing. (In Press). Journal of clinical sleep medicine American Academy of Sleep Medicine 10.5664/jcsm.9300

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STUDY OBJECTIVES

Night-to-night variability of obstructive sleep apnea severity (OSA) is considerable and may depend on the diagnostic modality used. We investigated the night-to-night variability using peripheral arterial tonometry (PAT).

METHODS

Home sleep apnea testing was performed in 51 patients during three consecutive nights using PAT. Patients referred to our sleep clinic were screened and prospectively recruited for this study. All recordings were automatically and manually scored according to the PAT scoring guidelines.

RESULTS

No systematic differences in pAHI were found between the nights. The night-to-night variability was comparable between manually and automatically scored data. PAT-derived apnea-hypopnea index (pAHI) varied in 35% of patients more than 10/h between the nights. The OSA severity of 24% of patients was misclassified when using one night compared to the average of all nights. On average, pAHI varied by 57% from night-to-night. The variability of pAHI could partially be explained by the variability of time spent in the supine position with more time supine leading to a higher pAHI. On measuring a subsequent night, 12-14% of patients spontaneously fulfilled the commonly accepted criteria for treatment success without any intervention.

CONCLUSIONS

With repeated recordings of PAT, we found no first night effect. However, there is considerable night-to-night variability similar to values found for polysomnography, which can partially be explained by the variability of time spent in the supine position. OSA severity was frequently misclassified due to the night-to-night variability. Our findings make a strong case for multiple testing in the diagnostic work-up of OSA patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Hearing Research Laboratory

UniBE Contributor:

Tschopp, Samuel; Wimmer, Wilhelm; Caversaccio, Marco and Borner, Urs

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1550-9389

Publisher:

American Academy of Sleep Medicine

Language:

English

Submitter:

Wilhelm Wimmer

Date Deposited:

11 May 2021 13:58

Last Modified:

11 May 2021 13:58

Publisher DOI:

10.5664/jcsm.9300

PubMed ID:

33783347

Uncontrolled Keywords:

home sleep apnea testing misclassification night-to-night variability obstructive obstructive sleep apnea peripheral arterial tonometry sleep apnea sleep study

URI:

https://boris.unibe.ch/id/eprint/155681

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