Comparison of Home Sleep Polygraphy or Laboratory Polysomnography for the Diagnosis of OSA Before Bariatric Surgery

In-laboratory polysomnography (PSG) is considered the gold standard for diagnosing obstructive sleep apnea (OSA). Our study aimed to compare whether home polygraphy (PG) could provide comparable diagnostic accuracy to PSG before bariatric surgery in a real-life cohort and to determine whether home PG is associated with a higher incidence of complications.

In a retrospective study, we compared 400 patients who performed home PG or laboratory PSG between January 2017 and March 2020. All patients included had to be incident cases and had to have undergone bariatric surgery after the sleep test.

Among the participants, 215 underwent PSG, while 185 underwent PG. Demographic characteristics such as age, sex, BMI, and Epworth sleepiness score were similar between groups. The apnea-hypopnea index was significantly lower in the PG group (21 ± 20 events/h) compared to the PSG group (29 ± 28 events/h) (p < 0.001). The proportion of patients treated with positive airway pressure was comparable between the two groups. Following bariatric surgery, the duration of hospitalization and the incidence of postoperative complications did not differ significantly between the two groups.

Our findings suggest that before bariatric surgery, home PG could identify patients requiring positive airway pressure as equivalent to in-laboratory PSG, without increasing postoperative complications.