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One negative polysomnogram does not exclude obstructive sleep apnea

T J Meyer1, S E Eveloff, L R Kline

  • 1Division of Pulmonary and Critical Care Medicine, Rhode Island Hospital, Providence 02903.

Chest
|March 1, 1993
PubMed
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Nightly variations in sleep apnea events can lead to false negatives. A single negative sleep study may not rule out obstructive sleep apnea (OSA) in at-risk individuals.

Area of Science:

  • Sleep Medicine
  • Respiratory Disorders

Background:

  • Obstructive sleep apnea (OSA) diagnosis relies on polysomnography.
  • Night-to-night variability in apnea events is recognized in diagnosed OSA patients.

Purpose of the Study:

  • To investigate if sleep study variability can lead to missed OSA diagnoses in clinically suspected patients.
  • To determine the reliability of a single negative polysomnography in identifying OSA.

Main Methods:

  • Prospective study of 11 patients with clinical suspicion of OSA but a negative initial polysomnography.
  • Second overnight polysomnography performed on patients with initial negative results.

Main Results:

  • Six out of 11 patients (54.5%) showed a positive result on the second study.

Related Experiment Videos

  • The apnea-hypopnea index (AHI) significantly increased from 3.1 to 19.8 (p < 0.01) in these patients.
  • The variability was not linked to risk factors, sleep architecture, or test interval, nor was it REM-dependent.

    • Conclusions:

    • A single negative polysomnography is insufficient to exclude OSA in patients with clinical indicators.
    • Further investigation or repeat testing may be necessary for patients with suspected OSA and a negative initial study.