IS THERE A WAY TO PREDICT ABNORMAL POLYSOMNOGRAPHY FOLLOWING A NEGATIVE HOME SLEEP APNEA TEST?

Abstract Introduction Obstructive sleep apnea (OSA) is characterized by recurrent episodes of obstruction of the upper airway that cause decreased or absent breathing during sleep. An OSA diagnosis is made when the patient experiences recurrent episodes of partial or complete collapse of the upper airway during sleep, which results in apneas or hypopneas, respectively. Polysomnography (PSG) is the gold standard test for diagnosis. HSATs (Home Sleep Apnea Tests) are types of sleep tests that can be conducted in a patient's home to detect obstructive sleep apnea. These tests are becoming increasingly common due to their affordability and convenience. Currently, an in-lab PSG is recommended if the initial HSAT is negative and there is a high clinical suspicion of OSA. Aim of this study is to identify a predictive component of negative HSAT which in turn shows positive PSG. Methods We reviewed 50 electronic medical records of patients who underwent an HSAT followed by an in-lab PSG at our Sleep Disorders Center. Patient demographics, comorbidities, HSAT data and PSG data were analyzed. Chi-square test and independent sample t-test were used to compare groups. Predictors of the negative PGA was assessed with Logistic regression. Statistical analysis was performed using Statistical Package of Social Science (SPSS) for Windows, version 15.0 (SPSS Inc, Chicago, IL). A p value <0.05 was considered as statistically significant. Results There was no correlation between age, gender, body mass index, comorbidities, and lowest oxygen level in HSAT to predict the result of following PSG. Conclusion The results of this study showed no statistically significant predictor in patients who underwent an HSAT followed by an in-lab PSG, although there seems to be a weak correlation between the lowest oxygen levels in HSAT and positive PSG. The gold standard for diagnosing OSA remains in-laboratory PSG; HSAT is an alternative in a select group of patients. For most patients with suspected mild OSA, in-laboratory PSG is preferred since HSAT may under-detect sleep-related events. Support (If Any)