Split-night polysomnography allows for the diagnosis of obstructive sleep apnea and titration of continuous positive airway pressure in a single study. However, there is concern that split-night studies do not provide sufficient time for optimal continuous positive airway pressure (CPAP) titration, which may lead to a poor initial experience with CPAP and potentially, worse adherence. Our goal was to determine whether CPAP use, after a split-night examination, is comparable to the use following separate diagnostic and titration studies.
We included consecutive patients presenting for follow-up 4–6 weeks after initiating CPAP therapy. Objective measures of CPAP use were recorded, and adherence to therapy was analyzed based on the initial method of diagnosis and titration—split-night versus dual-night study.
A total of 400 patients (78% male, mean age 47 ± 8 years) were included. Among the patients, 267 and 133 underwent split- and dual-night studies, respectively. The groups were similar at baseline; however, the average apnea-hypopnea index was significantly higher in the split-night group. Mean number of days between diagnosis and titration in the dual-night group was 80.5 days. There was no difference in therapeutic adherence between groups as measured by percentage of nights used (78.7% vs 77.5%; p = 0.42), hours per night used (3.9 vs 3.9; p = 0.95), or percentage of patients using continuous positive airway pressure for >4 hours per night for >70% of nights (52.9% vs 51.8%; p = 0.81). There was no difference in use after adjusting for severity of disease.
Split-night polysomnography does not adversely affect short-term continuous positive airway pressure adherence in patients with obstructive sleep apnea.
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body mass index
continuous positive airway pressure
Epworth sleepiness scale
obstructive sleep apnea
rapid eye movement sleep
slow wave sleep
American Academy of Sleep Medicine
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Conflict of Interest
The authors have no conflict of interest to disclose.
The views expressed in this paper are those of the authors and do not reflect the official policy of the Department of the Army, Department of Defense, or the US Government.
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Collen, J., Holley, A., Lettieri, C. et al. The impact of split-night versus traditional sleep studies on CPAP compliance. Sleep Breath 14, 93–99 (2010). https://doi.org/10.1007/s11325-009-0294-y
- Obstructive sleep apnea
- Continuous positive airway pressure
- Split-night polysomnography