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. 2022 Dec;26(4):1673-1681.
doi: 10.1007/s11325-021-02530-w. Epub 2021 Dec 31.

Sleep position, patient comfort, and technical performance with two established procedures for home sleep testing

C Emika Mueller  1 , Hansen Li  2 , Sophia M Begasse  2 , J Ulrich Sommer  3 , Boris A Stuck  2 , Richard Birk  2
Affiliations

Sleep position, patient comfort, and technical performance with two established procedures for home sleep testing

C Emika Mueller et al. Sleep Breath. 2022 Dec.

Abstract

Purpose: In patients with a high pre-test probability of suffering from obstructive sleep apnea (OSA), (cardio)-respiratory polygraphy (RP; level 3) is commonly used for home sleep testing (HST); however, testing based on peripheral arterial tonometry (PAT) is increasingly recognized as an alternative method. The aim of the study was to compare sleep position, patients' comfort, and technical failure rates of HST with RP and PAT in patients with suspected OSA.

Methods: Sleep position, patients' comfort, and technical failure rates of RP and PAT were compared in 56 patients receiving two nights of HST with either RP or PAT in a randomized fashion.

Results: Time in supine position with PAT was significantly lower (173.7±88 min) compared to RP (181.7±103.7 min; p < 0.001), although the absolute mean difference was not clinically significant. Patients reported to sleep better, feeling less disturbed when falling asleep, losing less sensors, and fewer nightly awakenings with PAT, but experienced more pain at the side of the finger probe. Forty-five out of 56 patients (80%) rated PAT as being the superior sleep test and 49 out of 56 (88%) would prefer PAT for further investigations (p<0.001). PAT testing was associated with less technical failures.

Conclusion: The results demonstrate that HST with PAT leads to less time in supine sleep positioning, which may be clinically relevant in selected patients. Moreover, PAT is associated with less technical failures and is perceived with less discomfort during testing and a reduced number of nocturnal awakenings in patient self-reports.

Keywords: Obstructive sleep apnea; Peripheral arterial tonometry; Polygraphy; Positional sleep apnea; Sleep position; Sleep-disordered breathing.

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Conflict of interest statement

BAS has received research grants, reimbursement of travel expenses, and speaking fees from Sutter Medizintechnik, Neuwirth Medical Products, Philips Healthcare, Itamar Medical, Inspire Medical, and SnooZeal Ltd. His department has received financial support for meetings or symposia from Löwenstein Medical, Inspire Medical, and Neuwirth Medical Products. He serves as a consultant for Itamar Medical und Signifier Medical Technologies. JUS or his department has received research grants, reimbursement of travel expenses, did consultancy work, or received speaking fees from Inspire Medical, Itamar Medical, Jazz Pharmaceuticals, Livanova, Löwenstein Medical, Neuwirth Medical Products, Nyxoah, Philips Healthcare, Somnomedics, Sutter Medizintechnik. RB has received research grants, reimbursement of travel expenses, and speaking fees from Neuwirth Medical Products, Philips Healthcare and Itamar Medical. CEM, HL, and SMB have no conflict of interest.

Figures

Fig. 1
Fig. 1
Box and whisker plot of time (minutes) spent in supine position with respiratory polygraphy (RP)– and peripheral arterial tonometry (PAT)–based examinations. The boxes represent the interquartile range (IQR) with the whiskers extending up to 1.5 times the IQR. The median is marked with a solid black line. Outliers are marked with a circle. Green box = PAT. Red box = RP
Fig. 2
Fig. 2
Overall sleeping comfort in respiratory polygraphy (RP)- and peripheral arterial tonometry (PAT)–based examinations. Self-reported sleeping comfort grades: 1 = best, 5 = worst. 6 = no rating reported. Red = RP. Green = PAT
Fig. 3
Fig. 3
Patient flow during the study
See this image and copyright information in PMC

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