title: Split-night studies for the diagnosis and treatment of sleep-disordered breathing.
abstract: We examined the effect of split-night polysomnography on compliance with positive pressure via a mask for the treatment of obstructive sleep-disordered breathing. A comparison of objective compliance (hours/day) at the first meter read from the positive-pressure device (4-6 weeks after set-up) in patients who had a successful split-night positive-pressure titration vs. patients who had traditional full-night positive-pressure titration was performed. Patients were matched for age, sex, and severity of the obstructive sleep-disordered breathing. Twelve patients were matched with controls who underwent full-night polysomnography. There were no significant differences between the split-night patients and the full-night patients with regard to age, sex, body mass index, and pretreatment Epworth Sleepiness Score. In addition, there was no significant difference between apnea-hypopnea index and the desaturation-event frequency for both groups pre- and post-treatment. The average daily use of continuous positive airway pressure (CPAP) at the time of the first meter reading in the group that underwent full-night positive-pressure titrations as opposed to split-night titrations was 5.2 hours/day +/- 2.2 vs. 3.8 hours/day +/- 2.9, respectively (p = 0.29). The Epworth Sleepiness Scale on the initial clinic visit (as an index of patient-perceived impairment) did not predict compliance at 4-6 weeks. The time at the final positive pressure did not correlate with compliance. Acceptance of positive pressure in the split-night patients ranged from 62 to 67%.
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh Medical Center, Pennsylvania, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Strollo
authors.forename: M H
authors.initials: MH
authors.lastname: Sanders
authors.forename: J P
authors.initials: JP
authors.lastname: Costantino
authors.forename: S K
authors.initials: SK
authors.lastname: Walsh
authors.forename: R A
authors.initials: RA
authors.lastname: Stiller
authors.forename: C W
authors.initials: CW
authors.lastname: Atwood
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011175:Positive-Pressure Respiration; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome