title: Predictors of successful completion of diagnostic home sleep testing in patients with chronic kidney disease.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) is common among patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Home sleep testing is used to diagnose OSA in many studies investigating sleep-disordered breathing in this population. However, failure to successfully complete the test is a significant source of participant exclusion from research studies and delayed diagnosis in clinical practice. The objective of the study was to identify potential factors impeding acceptance and successful completion of home sleep testing in patients with kidney disease.
  
  
  METHODS
  Four hundred and nineteen patients were recruited from nephrology clinics and dialysis units. Following completion of a sleep and medical history questionnaire, all patients were invited to perform a single night, home sleep study. Acceptance or refusal of the test was noted, as well as the success of the sleep study, as determined by a review of the raw data by a sleep medicine physician.
  
  
  RESULTS
  Male gender (OR = 1.61, CI = 1.02-2.53), hypertension (OR = 2.01, CI = 1.17-3.45), and snoring (OR = 1.75, CI = 1.11-2.77) were associated with sleep test acceptance. Older patients were less likely to accept the test (OR = 0.48, CI = 0.30-0.76). Diabetics were less likely to complete the sleep test successfully (OR = 0.28, CI = 0.12-0.66).
  
  
  CONCLUSIONS
  Advanced age is an important factor in test refusal and complications of diabetes contributes to test failure. Symptom matching may be a source of selection bias, as patients with risk factors for OSA are more likely to accept the diagnostic test.
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lee
authors.forename: Tanvir C
authors.initials: TC
authors.lastname: Turin
authors.forename: David D M
authors.initials: DD
authors.lastname: Nicholl
authors.forename: Sofia B
authors.initials: SB
authors.lastname: Ahmed
authors.forename: Andrea H S
authors.initials: AH
authors.lastname: Loewen
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Hemmelgarn
authors.forename: Abul K
authors.initials: AK
authors.lastname: Azad
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Hanly
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D018575:Home Care Services, Hospital-Based; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D017286:Polysomnography / Q000379:methods*; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*