title: Unattended home-based polysomnography for sleep disordered breathing: current concepts and perspectives.
abstract: Recently, portable sleep recording devices became an accepted alternative to polysomnography (PSG) for obstructive sleep apnea (OSA) diagnosis in patients with a high pre-test probability of moderate to severe OSA but home polysomnography (H-PSG) was not recommended because there were insufficient data. The present review has analysed six prospective randomized crossover studies comparing H-PSG to in-lab PSG. These studies convincingly showed that H-PSG allows complete sleep evaluation. The quality of patients' sleep tends to be better at home. H-PSG is accurate for OSA diagnosis and the failure rate is low despite the absence of supervision. In addition, it could offer a final and comprehensive diagnosis for many other sleep disorders. It is also likely that H-PSG can reduce PSG-related costs but complete cost-effectiveness analyses are not yet available. Recently, remotely attended H-PSG via telemonitoring has been tested and may reduce H-PSG failure rate. In conclusion, H-PSG can be used to rule-in and rule out OSA in suspected patients, even in the presence of co-morbidities and is an alternative when simplified sleep testing is negative. Future developments should target simplification of technical aspects of H-PSG, together with remote monitoring, in order to obtain good quality H-PSG performed in adequate conditions.
authors.affiliation: Chest Service, Saint-Pierre University Hospital, Rue Haute, 322, 1000 Brussels, Belgium. Electronic address: Marie_Bruyneel@stpierre-bru.be.
authors.forename: Marie
authors.initials: M
authors.lastname: Bruyneel
authors.affiliation: Chest Service, Saint-Pierre University Hospital, Rue Haute, 322, 1000 Brussels, Belgium.
authors.forename: Vincent
authors.initials: V
authors.lastname: Ninane
mesh_terms: D006801:Humans; D017286:Polysomnography / Q000379:methods*; D012648:Self Care / Q000295:instrumentation / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology
keywords: Home unattended polysomnography; Obstructive sleep apnea; Sleep disorders; Sleep quality; Telemedicine