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Internight Variability of Apnea-Hypopnea Index in Obstructive Sleep Apnea Using Ambulatory Polysomnography.
Emilia Sforza1, Frédéric Roche1, Céline Chapelle2
1EA SNA EPIS Service de Physiologie Clinique et de l'Exercice (Pole Hospitalier NOL), CHU de Saint-Étienne, Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, Université de Lyon, Saint-Étienne, France.
Frontiers in Physiology
|July 30, 2019
Summary
Obstructive sleep apnea (OSA) severity can vary between nights due to sleep position and the "first night effect." A second polysomnography (PSG) night may be beneficial for diagnosing mild OSA cases with clinical uncertainty.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
Background:
- Obstructive sleep apnea (OSA) patients exhibit increased respiratory event severity in supine positions.
- Night-to-night variability in OSA severity may be influenced by postural preferences and the
- first night effect.
Purpose of the Study:
- To assess the internight variability of polysomnography (PSG) in a large cohort of OSA patients.
- To identify factors contributing to this observed variability in OSA severity.
Main Methods:
- 188 patients with suspected OSA underwent two consecutive nights of at-home PSG.
- Analysis considered age, gender, obesity, neck circumference, sleep position, and sleep parameters to explain respiratory index variations.
Main Results:
- The apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) tended to decrease on the second night.
- Mild OSA cases showed increased AHI with more supine time on the second night.
- Severe OSA cases demonstrated decreased AHI and ODI on the second night, irrespective of sleep position.
Conclusions:
- Inter-night variability in AHI and ODI is linked to sleep structure, fragmentation, and sleep position.
- Given greater variability in mild OSA, a second PSG night is recommended for cases with clinical uncertainty.
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