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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol
DOI: 10.1055/s-0043-1769495
Systematic Reviews

Evaluation of Minimum Recording Time and the Influence of Time in the Supine Position on Out-of-Center Sleep Tests

Raquel Chartuni Teixeira 
1   Department of Otolaryngology, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
,
Michel Burihan Cahali 
1   Department of Otolaryngology, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
› Author Affiliations Funding The author(s) received no financial support for the research.
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Abstract

Introduction The prevalence of moderate to severe sleep-disordered breathing is of 17% among men aged between 50 and 70-years, and of 9% among women in the same age group. In Brazil, obstructive sleep apnea (OSA) is also highly prevalent, and it is associated with metabolic and cardiovascular impacts, excessive daytime sleepiness, and increasing risk of traffic accidents. Laboratory-based polysomnography is the gold standard test for OSA diagnosis. However, its complexity has led to the search for alternatives to simplify the diagnosis, such as the out-of-center sleep test (OCST).

Objectives To discusses the minimum OCST recording time and the potential effects of the supine position on this parameter.

Data Synthesis We conducted a search on the PubMed, Web of Science, Scopus, and Embase databases to identify relevant studies on OCST recording time and a possible association with body position. We used a combination of terms, including Obstructive Sleep Apnea and Home Monitoring OR Home Care Services OR Portable Monitoring AND Supine OR Position OR Recording Time OR Positional Obstructive Sleep Apnea. The references of the selected articles were also reviewed to find other relevant studies. Through our approach, eighteen articles were retrieved and included in the present study.

Conclusion Since OCSTs are conducted in an unattended environment, with potential signal loss during the night, it is crucial to determine the minimum recording time to validate the test and assess how the time spent in the supine position affects this parameter. After reviewing the literature, this topic remains to be clarified, and additional studies should focus on that matter.

Keywords

sleep apnea - obstructive - polysomnography - monitoring - ambulatory care


Publication History

Received: 17 April 2022

Accepted: 19 April 2023

Article published online:
29 November 2023

© 2023. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Collop NA, Tracy SL, Kapur V. et al. Obstructive sleep apnea devices for out-of-center (OOC) testing: technology evaluation. J Clin Sleep Med 2011; 7 (05) 531-548
    CrossrefPubMedGoogle Scholar
  • 2 Budhiraja R, Budhiraja P, Quan SF. Sleep-disordered breathing and cardiovascular disorders. Respir Care 2010; 55 (10) 1322-1332 , discussion 1330–1332
    PubMedGoogle Scholar
  • 3 Lam JCM, Mak JCW, Ip MSM. Obesity, obstructive sleep apnoea and metabolic syndrome. Respirology 2012; 17 (02) 223-236
    CrossrefPubMedGoogle Scholar
  • 4 Tefft BC. Prevalence of motor vehicle crashes involving drowsy drivers, United States, 1999-2008. Accid Anal Prev 2012; 45: 180-186
    CrossrefPubMedGoogle Scholar
  • 5 Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013; 177 (09) 1006-1014
    CrossrefPubMedGoogle Scholar
  • 6 Tufik S, Santos-Silva R, Taddei JA, Bittencourt LRA. Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med 2010; 11 (05) 441-446
    CrossrefPubMedGoogle Scholar
  • 7 Ferreira APS, Szwarcwald CL, Damacena GN. Prevalência e fatores associados da obesidade na população brasileira: estudo com dados aferidos da Pesquisa Nacional de Saúde, 2013. Rev Bras Epidemiol 2019; 22: e190024
    CrossrefPubMedGoogle Scholar
  • 8 Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest 2014; 146 (05) 1387-1394
    CrossrefPubMedGoogle Scholar
  • 9 Kushida CA, Littner MR, Morgenthaler T. et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 2005; 28 (04) 499-521
    CrossrefPubMedGoogle Scholar
  • 10 Pevernagie DA, Gnidovec-Strazisar B, Grote L. et al. On the rise and fall of the apnea-hypopnea index: A historical review and critical appraisal. J Sleep Res 2020; 29 (04) e13066
    CrossrefPubMedGoogle Scholar
  • 11 Azarbarzin A, Sands SA, Stone KL. et al. The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: the Osteoporotic Fractures in Men Study and the Sleep Heart Health Study. Eur Heart J 2019; 40 (14) 1149-1157
    CrossrefPubMedGoogle Scholar
  • 12 Linz D, Loffler KA, Sanders P. et al; SAVE (Sleep Apnea Cardiovascular Endpoints) Investigators. Low Prognostic Value of Novel Nocturnal Metrics in Patients With OSA and High Cardiovascular Event Risk: Post Hoc Analyses of the SAVE Study. Chest 2020; 158 (06) 2621-2631
    CrossrefPubMedGoogle Scholar
  • 13 Ho V, Crainiceanu CM, Punjabi NM, Redline S, Gottlieb DJ. Calibration Model for Apnea-Hypopnea Indices: Impact of Alternative Criteria for Hypopneas. Sleep 2015; 38 (12) 1887-1892
    CrossrefPubMedGoogle Scholar
  • 14 Pinheiro GDL, Cruz AF, Domingues DM. et al. Validation of an Overnight Wireless High-Resolution Oximeter plus Cloud-Based Algorithm for the Diagnosis of Obstructive Sleep Apnea. Clinics (São Paulo) 2020; 75: e2414
    CrossrefPubMedGoogle Scholar
  • 15 Bittencourt LR, Suchecki D, Tufik S. et al. The variability of the apnoea-hypopnoea index. J Sleep Res 2001; 10 (03) 245-251
    CrossrefPubMedGoogle Scholar
  • 16 Kapur VK, Auckley DH, Chowdhuri S. et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: An American academy of sleep medicine clinical practice guideline. J Clin Sleep Med 2017; 13 (03) 479-504
    CrossrefPubMedGoogle Scholar
  • 17 Mello AAF, , D Angelo G, Santos RB. et al. Influence of the device used for obstructive sleep apnea diagnosis on body position: a comparison between polysomnography and portable monitor. Sleep Breath 2022 Available from: https://link.springer.com/10.1007/s11325-022-02674-3
    Google Scholar
  • 18 Mador MJ, Kufel TJ, Magalang UJ, Rajesh SK, Watwe V, Grant BJ. Prevalence of positional sleep apnea in patients undergoing polysomnography. Chest 2005; 128 (04) 2130-2137 Available from: www.chestjournal.org
    CrossrefPubMedGoogle Scholar
  • 19 Marklund M, Persson M, Franklin KA. Treatment success with a mandibular advancement device is related to supine-dependent sleep apnea. Chest 1998; 114 (06) 1630-1635
    CrossrefPubMedGoogle Scholar
  • 20 Permut I, Diaz-Abad M, Chatila W. et al. Comparison of positional therapy to CPAP in patients with positional obstructive sleep apnea. J Clin Sleep Med 2010; 6 (03) 238-243
    CrossrefPubMedGoogle Scholar
  • 21 Ravesloot MJL, White D, Heinzer R, Oksenberg A, Pépin JL. Efficacy of the new generation of devices for positional therapy for patients with positional obstructive sleep apnea: A systematic review of the literature and meta-Analysis. J Clin Sleep Med 2017; 13 (06) 813-824
    CrossrefPubMedGoogle Scholar
  • 22 Wittine LM, Olson EJ, Morgenthaler TI. Effect of recording duration on the diagnostic accuracy of out-of-center sleep testing for obstructive sleep apnea. Sleep 2014; 37 (05) 969-975
    CrossrefPubMedGoogle Scholar
  • 23 Ng SSS, Chan TO, To KW. et al. Validation of a portable recording device (ApneaLink) for identifying patients with suspected obstructive sleep apnoea syndrome. Intern Med J 2009; 39 (11) 757-762
    CrossrefPubMedGoogle Scholar
  • 24 Cheliout-Heraut F, Senny F, Djouadi F, Ouayoun M, Bour F. Obstructive sleep apnoea syndrome: comparison between polysomnography and portable sleep monitoring based on jaw recordings. Neurophysiol Clin 2011; 41 (04) 191-198
    CrossrefPubMedGoogle Scholar
  • 25 Driver HS, Pereira EJ, Bjerring K. et al. Validation of the MediByte® type 3 portable monitor compared with polysomnography for screening of obstructive sleep apnea. Can Respir J 2011; 18 (03) 137-143
    CrossrefPubMedGoogle Scholar
  • 26 Reichert JA, Bloch DA, Cundiff E, Votteri BA. Comparison of the NovaSom QSG, a new sleep apnea home-diagnostic system, and polysomnography. Sleep Med 2003; 4 (03) 213-218
    CrossrefPubMedGoogle Scholar
  • 27 Yin M, Miyazaki S, Ishikawa K. Evaluation of type 3 portable monitoring in unattended home setting for suspected sleep apnea: factors that may affect its accuracy. Otolaryngol Head Neck Surg 2006; 134 (02) 204-209
    CrossrefPubMedGoogle Scholar
  • 28 Kingshott RN, Douglas NJ. The effect of in-laboratory polysomnography on sleep and objective daytime sleepiness. Sleep 2000; 23 (08) 1109-1113
    CrossrefPubMedGoogle Scholar
  • 29 Masa JF, Corral J, Pereira R. et al. Effectiveness of home respiratory polygraphy for the diagnosis of sleep apnoea and hypopnoea syndrome. Thorax 2011; 66 (07) 567-573
    CrossrefPubMedGoogle Scholar
  • 30 Hernández-Bendezú MDC, Arias-Peña MY, Torres-Fraga MG, Carrillo-Alduenda JL. Quality of an ambulatory monitoring technique for diagnosing obstructive sleep apnea under conditions of limited resources. Sleep Sci 2018; 11 (04) 269-273
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Hsu HC, Chen NH, Ho WJ, Lin MH. Factors associated with undiagnosed obstructive sleep apnoea among hypertensive patients: A multisite cross-sectional survey study in Taiwan. J Clin Nurs 2018; 27 (9-10): 1901-1912
    CrossrefPubMedGoogle Scholar
  • 32 Oliveira MG, Nery LE, Santos-Silva R. et al. Is portable monitoring accurate in the diagnosis of obstructive sleep apnea syndrome in chronic pulmonary obstructive disease?. Sleep Med 2012; 13 (08) 1033-1038
    CrossrefPubMedGoogle Scholar
  • 33 Guerrero A, Embid C, Isetta V. et al. Management of sleep apnea without high pretest probability or with comorbidities by three nights of portable sleep monitoring. Sleep 2014; 37 (08) 1363-1373
    CrossrefPubMedGoogle Scholar
  • 34 Gjevre JA, Taylor-Gjevre RM, Skomro R, Reid J, Fenton M, Cotton D. Comparison of polysomnographic and portable home monitoring assessments of obstructive sleep apnea in Saskatchewan women. Can Respir J 2011; 18 (05) 271-274
    CrossrefPubMedGoogle Scholar
  • 35 Vonk PE, de Vries N, Ravesloot MJL. Polysomnography and sleep position, a Heisenberg phenomenon?: A large-scale series. HNO 2019; 67 (09) 679-684
    CrossrefPubMedGoogle Scholar
  • 36 Levendowski D, Steward D, Woodson BT, Olmstead R, Popovic D, Westbrook P. The impact of obstructive sleep apnea variability measured in-lab versus in-home on sample size calculations. Int Arch Med 2009; 2 (01) 2 . Published 2009 Jan 2. doi:10.1186/1755-7682-2-2
    CrossrefPubMedGoogle Scholar
  • 37 Ng SSS, Chan TO, To KW. et al. Validation of Embletta portable diagnostic system for identifying patients with suspected obstructive sleep apnoea syndrome (OSAS). Respirology 2010; 15 (02) 336-342
    CrossrefPubMedGoogle Scholar