Diagnosis of Sleep-Disordered Breathing in the Home Environment

Polysomnography, a gold standard for the diagnosis of sleep-disordered breathing, is a complex investigation requiring access to the sleep laboratory. Thus, sleep-disordered breathing could be underdiagnosed. The aim of this paper was to investigate the feasibility and effectiveness of self-performed investigation of obstructive sleep apnea (OSA) in the home setting, using a portable device, and to assess the comfort and simplicity of the procedure from the patient's perspective. The study included 68 middle-aged patients (21 women and 47 men), who were examined at home with the ApneaLink Air device in search for the underlying reason of reported nighttime snoring and occasionally disordered breathing pattern. The apnea-hypopnea index was quantified and matched with body mass index (BMI), age, and other characteristics. OSA was diagnosed in 37 patients (27 men and 10 women): 22 had mild, 4 had moderate, and 11 patients had severe OSA. All cases of severe OSA were present in men. Patients with severe OSA had significantly higher BMI than those from the other groups. All of the patients pointed to the comfort and ease of the diagnostic device. We conclude that home diagnosis of OSA is a relatively easy and cost-effective way to substitute for the hospital-linked polysomnography, particularly in severely ill patients who have a movement difficulty. A wider implementation of home-based diagnosis of OSA may substantially increase the number of patients investigated in a short time span, also leading to the plausibly upward correction of the disease prevalence.