, Volume 15, Issue 3, pp 367-375
Date: 16 Mar 2010

Perioperative practical experiences in using a level 2 portable polysomnography

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Abstract

Purpose

The objective of the study is to test the hypothesis that a level 2 portable sleep device (Embletta X100) is a reliable alternative for standard PSG in surgical patients.

Methods

After hospital ethics approvals, preoperative patients over 18 years old were recruited. The patients for validation underwent standard PSG and Embletta X100 simultaneously in a sleep laboratory before surgery. The other patients received sleep studies with Embletta X100 perioperatively. The correlation analysis and paired Student t test between variables from Embletta and from standard PSG were used to evaluate the accuracy of Embletta. The quality of PSG recordings with Embletta was summarized.

Result

Twenty-one patients completed sleep study on both systems; ten females and ten males, age was 54 ± 11 and BMI was 36 ± 9. There was a significant correlation between the majority of parameters from standard PSG and Embeltta X100 with manual scoring. The inter-rater agreement was substantial to perfect at different AHI cutoffs with a Kappa coefficient of 0.69 to 1. A significant correlation between standard PSG and Embletta X100 with automatic scoring was found only in AHI and a few other parameters. In 385 patients, 1,002 perioperative PSG recordings were carried out with Embletta. Of them, 889(88.7%) were technically good and 90(9%) technically acceptable. Only 23 (2.3%) PSG recordings failed.

Conclusion

Embletta X100, installed by a well-trained sleep technician, is a good alternative when standard PSG was not available or impractical. Manual scoring by a certified PSG technologist is the key for reliable results.

Sources of financial support for the work (including institutional support)

University Health Network Foundation, Physician Services Incorporated Foundation, ResMed Foundation, and Respironic Foundation. University of Toronto for Dr. Chung and Dr. Shapiro.