title: Rethinking AASM guideline for split-night polysomnography in Asian patients with obstructive sleep apnea.
abstract: OBJECTIVE
  Split-night polysomnography (SN-PSG) provides both a diagnosis and titration of continuous positive airway pressure over a single night in patients with suspected obstructive sleep apnea (OSA). However, in Asian patients, the diagnostic validity of American Academy of Sleep Medicine (AASM) guidelines for SN-PSG remains uncertain. Therefore, we examined whether the current criteria for SN-PSG are pertinent for Asian patients.
  
  
  METHODS
  We investigated 134 consecutive patients who were diagnosed with OSA (apnea-hypopnea index (AHI) ≥ 5). We divided the raw data (full-night study) into two parts and compared the first 2 h of sleep with the full night of sleep to evaluate the diagnostic precision and accuracy of the first 2 h of sleep.
  
  
  RESULTS
  No difference in AHI was observed between the first 2 h and the full night of sleep. A significant correlation of AHI was observed between the first 2 h and the full night of sleep for severe OSA patients (AHI ≥ 30). A correlation coefficient of AHI was higher by the criterion of AHI ≥ 30 than by the criterion of AHI ≥ 40 (r = 0.831 and r = 0.778, respectively), which is the current AASM criterion for SN-PSG. Moreover, the criterion AHI ≥ 30 showed better diagnostic accuracy than the criterion AHI ≥ 40 (89.3 and 88.7 %, respectively).
  
  
  CONCLUSIONS
  This study found possible evidence supporting different diagnostic criteria for SN-PSG in Asian population. We suggest further studies in other Asian populations to confirm these findings.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital and Nano-Bio Regenerative Medical Institute, Hallym University College of Medicine, Chuncheon, Republic of Korea.
authors.forename: Dong-Kyu
authors.initials: DK
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University, Seoul, Korea.
authors.forename: Jihye
authors.initials: J
authors.lastname: Choi
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University, Seoul, Korea.
authors.forename: Kyung Rae
authors.initials: KR
authors.lastname: Kim
authors.affiliation: Dentistry, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Kyung-Gyun
authors.initials: KG
authors.lastname: Hwang
authors.affiliation: Department of Occupational and Envrionmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seungho
authors.initials: S
authors.lastname: Ryu
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University, Seoul, Korea. shcho@hanyang.ac.kr.|Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222-Wangshimniro, Seongdong-gu, Seoul, 133-792, Korea. shcho@hanyang.ac.kr.
authors.forename: Seok Hyun
authors.initials: SH
authors.lastname: Cho
mesh_terms: D000328:Adult; D044466:Asian People; D045422:Continuous Positive Airway Pressure; D003431:Cross-Cultural Comparison; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D056910:Republic of Korea; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000208:ethnology* / Q000628:therapy; D013223:Statistics as Topic; D016896:Treatment Outcome
keywords: Apnea-hypopnea index; Asian; Diagnostic accuracy; Obstructive sleep apnea; Polysomnography; Split-night polysomnography