title: [Cost-effectiveness and degree of satisfaction with home sleep monitoring in patients with symptoms of sleep apnea].
abstract: OBJECTIVE
  To assess the diagnostic validity, degree of patient satisfaction, and economic cost of home sleep monitoring compared to conventional polysomnography.
  
  
  METHODS
  Consecutive patients with symptoms indicative of sleep apnea-hypopnea syndrome (SAHS) were included. We analyzed the diagnostic yield of home sleep monitoring using the apnea-hypopnea index (AHI), number of desaturations of at least 3%, and the percentage time with arterial oxygen saturation below 90%. The degree of patient satisfaction, measured on a visual analogue scale, and the cost of home monitoring were compared with conventional polysomnography.
  
  
  RESULTS
  The study included 52 patients (42 men and 10 women) with a mean (SD) age of 51.8 (9) years and a body mass index of 32 (5) kg/m2. Polysomnography and home monitoring revealed an AHI of 33.6 (20) and 31 (19), respectively (r=0.971; intraclass correlation coefficient = 0.963; P< .001). The number of desaturations of at least 3% and the percentage time with arterial oxygen saturation below 90% showed significant correlation and concordance (P< .05). For an AHI cutoff of 10 recorded with polysomnography, home monitoring had a sensitivity of 89% and a specificity of 80%, with an area under the receiver operator characteristic curve of 0.804. For severe SAHS (AHI> or =30), the sensitivity and specificity of home monitoring was 100% (that is, the area under the receiver operating characteristic curve was 1). For home monitoring, the cost per diagnostic test was 101.34 euro less than that of polysomnography, and the patient satisfaction was significantly greater (P< .0001).
  
  
  CONCLUSIONS
  Home sleep monitoring is a valid and cost-effective diagnostic test; patients with symptoms of SAHS are more satisfied with this technique than conventional polysomnography.
authors.affiliation: Servicio de Neumología, Hospital Universitario Reina Sofía, Córdoba, España. bjg01co@hotmail.com
authors.forename: Bernabé
authors.initials: B
authors.lastname: Jurado Gámez
authors.forename: Javier
authors.initials: J
authors.lastname: Redel Montero
authors.forename: Luis
authors.initials: L
authors.lastname: Muñoz Cabrera
authors.forename: Mari Carmen
authors.initials: MC
authors.lastname: Fernández Marín
authors.forename: Elisa
authors.initials: E
authors.lastname: Muñoz Gomáriz
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Martín Pérez
authors.forename: Andrés
authors.initials: A
authors.lastname: Cosano Povedano
mesh_terms: D003362:Cost-Benefit Analysis; D005260:Female; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D017286:Polysomnography / Q000191:economics*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000191:economics*; D013030:Spain