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Methodological strategies in using home sleep apnea testing in research and practice

Abstract

Purpose

Home sleep apnea testing (HSAT) has increased due to improvements in technology, accessibility, and changes in third party reimbursement requirements. Research studies using HSAT have not consistently reported procedures and methodological challenges. This paper had two objectives: (1) summarize the literature on use of HSAT in research of adults and (2) identify methodological strategies to use in research and practice to standardize HSAT procedures and information.

Methods

Search strategy included studies of participants undergoing sleep testing for OSA using HSAT. MEDLINE via PubMed, CINAHL, and Embase with the following search terms: “polysomnography,” “home,” “level III,” “obstructive sleep apnea,” and “out of center testing.”

Results

Research articles that met inclusion criteria (n = 34) inconsistently reported methods and methodological challenges in terms of: (a) participant sampling; (b) instrumentation issues; (c) clinical variables; (d) data processing; and (e) patient acceptability. Ten methodological strategies were identified for adoption when using HSAT in research and practice.

Conclusions

Future studies need to address the methodological challenges summarized in this paper as well as identify and report consistent HSAT procedures and information.

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Abbreviations

AASM:

American Academy of Sleep Medicine

AHI:

Apnea hypopnea index

HSAT:

Home sleep apnea testing

RDI:

Respiratory disturbance index

ODI:

Oxygen desaturation index

OSA:

Obstructive sleep apnea

PSG:

Polysomnogram

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Correspondence to Jennifer N. Miller.

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Miller, J.N., Schulz, P., Pozehl, B. et al. Methodological strategies in using home sleep apnea testing in research and practice. Sleep Breath 22, 569–577 (2018). https://doi.org/10.1007/s11325-017-1593-3

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Keywords

  • Obstructive sleep apnea
  • Home sleep apnea testing
  • Screening
  • Assessment
  • Diagnosis