Dong-Kyu Kim1, Jihye Choi2, Kyung Rae Kim2, Kyung-Gyun Hwang3, Seungho Ryu4, Seok Hyun Cho5,6. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital and Nano-Bio Regenerative Medical Institute, Hallym University College of Medicine, Chuncheon, Republic of Korea. 2. Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University, Seoul, Korea. 3. Dentistry, College of Medicine, Hanyang University, Seoul, Korea. 4. Department of Occupational and Envrionmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. 5. Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University, Seoul, Korea. shcho@hanyang.ac.kr. 6. Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222-Wangshimniro, Seongdong-gu, Seoul, 133-792, Korea. shcho@hanyang.ac.kr.
Abstract
PURPOSE: Split-night polysomnography (SN-PSG) provides both a diagnosis and titration of continuous positive airway pressure over a single night in patients with suspected obstructive sleep apnea (OSA). However, in Asian patients, the diagnostic validity of American Academy of Sleep Medicine (AASM) guidelines for SN-PSG remains uncertain. Therefore, we examined whether the current criteria for SN-PSG are pertinent for Asian patients. METHOD: We investigated 134 consecutive patients who were diagnosed with OSA (apnea-hypopnea index (AHI) ≥ 5). We divided the raw data (full-night study) into two parts and compared the first 2 h of sleep with the full night of sleep to evaluate the diagnostic precision and accuracy of the first 2 h of sleep. RESULTS: No difference in AHI was observed between the first 2 h and the full night of sleep. A significant correlation of AHI was observed between the first 2 h and the full night of sleep for severe OSA patients (AHI ≥ 30). A correlation coefficient of AHI was higher by the criterion of AHI ≥ 30 than by the criterion of AHI ≥ 40 (r = 0.831 and r = 0.778, respectively), which is the current AASM criterion for SN-PSG. Moreover, the criterion AHI ≥ 30 showed better diagnostic accuracy than the criterion AHI ≥ 40 (89.3 and 88.7 %, respectively). CONCLUSIONS: This study found possible evidence supporting different diagnostic criteria for SN-PSG in Asian population. We suggest further studies in other Asian populations to confirm these findings.
PURPOSE: Split-night polysomnography (SN-PSG) provides both a diagnosis and titration of continuous positive airway pressure over a single night in patients with suspected obstructive sleep apnea (OSA). However, in Asian patients, the diagnostic validity of American Academy of Sleep Medicine (AASM) guidelines for SN-PSG remains uncertain. Therefore, we examined whether the current criteria for SN-PSG are pertinent for Asian patients. METHOD: We investigated 134 consecutive patients who were diagnosed with OSA (apnea-hypopnea index (AHI) ≥ 5). We divided the raw data (full-night study) into two parts and compared the first 2 h of sleep with the full night of sleep to evaluate the diagnostic precision and accuracy of the first 2 h of sleep. RESULTS: No difference in AHI was observed between the first 2 h and the full night of sleep. A significant correlation of AHI was observed between the first 2 h and the full night of sleep for severe OSA patients (AHI ≥ 30). A correlation coefficient of AHI was higher by the criterion of AHI ≥ 30 than by the criterion of AHI ≥ 40 (r = 0.831 and r = 0.778, respectively), which is the current AASM criterion for SN-PSG. Moreover, the criterion AHI ≥ 30 showed better diagnostic accuracy than the criterion AHI ≥ 40 (89.3 and 88.7 %, respectively). CONCLUSIONS: This study found possible evidence supporting different diagnostic criteria for SN-PSG in Asian population. We suggest further studies in other Asian populations to confirm these findings.
Authors: Imran S Khawaja; Eric J Olson; Christelle van der Walt; Jan Bukartyk; Virend Somers; Ross Dierkhising; Timothy I Morgenthaler Journal: J Clin Sleep Med Date: 2010-08-15 Impact factor: 4.062
Authors: Bing Lam; Clara G C Ooi; Wilfred C G Peh; I Lauder; Kenneth W T Tsang; Wah-Kit Lam; Mary S M Ip Journal: Respir Med Date: 2004-04 Impact factor: 3.415