title: The success rate of split-night polysomnography and its impact on continuous positive airway pressure compliance.
abstract: OBJECTIVE
  With the increased volume of referrals of patients with obstructive sleep apnea (OSA) for sleep studies, there is a great need for alternatives of the standard two-night polysomnography (PSG) like split-night PSG. Therefore, we conducted this study to determine the success rate of continuous positive airway pressure (CPAP) titration during split-night PSG, and to determine the predictors of titration success and the impact on subsequent CPAP compliance in Saudi patients with OSA.
  
  
  METHODS
  This is a prospective cohort study that included consecutive patients who were diagnosed with OSA and underwent a split-night PSG (n = 454). A subgroup of patients who used CPAP therapy, agreed to come for follow-up after 4 and 10 months (n = 130). This subgroup was compared with a matched group of OSA patients who underwent a two-night sleep study protocol (n = 80).
  
  
  RESULTS
  The study group had a mean age of 48.7 ± 13.3 years, body mass index (BMI) of 37.5 ± 10.1 kg/m(2) and apnea hypopnea index of 58.4 ± 35.0 events/h. Successful CPAP titration was achieved in 350 (77%) patients. In a full adjusted model, "BMI >35 kg/m(2)" and "known cardiac disease" remained significant predictors of a lower success rate of CPAP titration. After 10 months, 88% of the patients in the split-night protocol met the set criteria for good compliance versus 85% in the two-night protocol.
  
  
  CONCLUSIONS
  Split-night protocol is an effective protocol for diagnosing OSA and titrating CPAP. CPAP compliance rate showed no difference between the split-night and the two-night protocols.
authors.affiliation: Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia and the Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation, Kingdome of Saudi Arabia.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: BaHammam
authors.affiliation: Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia and the Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation, Kingdome of Saudi Arabia.
authors.forename: Eiman
authors.initials: E
authors.lastname: ALAnbay
authors.affiliation: Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia and the Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation, Kingdome of Saudi Arabia.
authors.forename: Nuha
authors.initials: N
authors.lastname: Alrajhi
authors.affiliation: Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia and the Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation, Kingdome of Saudi Arabia.
authors.forename: Awad H
authors.initials: AH
authors.lastname: Olaish
keywords: Continuous positive airway pressure; obstructive sleep apnea; polysomnography; split-night sleep study