03214nas a2200397 4500008004100000022001400041245013100055210006900186260001600255300001100271490000700282520206700289653001002356653000902366653002002375653003502395653001902430653001802449653002302467653001102490653001602501653002002517653002602537653001502563100001702578700001902595700002802614700002002642700001502662700002402677700002002701700002402721700001802745700001802763856003502781 2004 eng d a0161-810500aPolysomnography performed in the unattended home versus the attended laboratory setting--Sleep Heart Health Study methodology.0 aPolysomnography performed in the unattended home versus the atte c2004 May 01 a536-400 v273 a
STUDY OBJECTIVE: To compare polysomnographic recordings obtained in the home and laboratory setting.
DESIGN AND SETTING: Multicenter study comparing unsupervised polysomnography performed in the participant's home with polysomnography supervised at an academic sleep disorders center, using a randomized sequence of study setting. Sleep Heart Health Study (SHHS) standardized polysomnographic recording and scoring techniques were used for both settings.
PARTICIPANTS: 64 of 76 non-SHHS participants recruited from 7 SHHS field sites who had both a laboratory and home polysomnogram meeting acceptable quality criteria.
MEASUREMENTS AND RESULTS: Median sleep duration was greater in the home than in the laboratory (375 vs 318 minutes, respectively, P < .0001) as was sleep efficiency (86% vs 82%, respectively, P < .0024). Very small, but significant increases in percentage of rapid eye movement sleep and decreases in stage 1 sleep were noted in the laboratory. Employing multiple definitions of respiratory disturbance index (RDI), median RDI was similar in both settings (for example, RDI with 3% desaturation: home 12.4, range 0.6-67; laboratory 9.5, range 0.1-93.4, P = .41). Quartile analysis of laboratory RDI showed moderate agreement with home RDI measurements. Based on the mean of laboratory and home RDI and using a cutpoint of 20, there was a biphasic distribution, with the RDI 3% above 20 being more common in the recordings performed in the laboratory than in the home and below 20 being more common in the recordings performed in the home than in the laboratory. These differences could not be attributed to quality of recording, age, sex, or body mass index.
CONCLUSIONS: Using SHHS methodology, median RDI was similar in the unattended home and attended laboratory setting with differences of small magnitude in some sleep parameters. Differences in RDI between settings resulted in a rate of disease misclassification that is similar to repeated studies in the same setting.
10aAdult10aAged10aBody Mass Index10aClinical Laboratory Techniques10aCohort Studies10aHealth Status10aHome Care Services10aHumans10aMiddle Aged10aPolysomnography10aSleep Apnea Syndromes10aSleep, REM1 aIber, Conrad1 aRedline, Susan1 aGilpin, Adele, M Kaplan1 aQuan, Stuart, F1 aZhang, Lin1 aGottlieb, Daniel, J1 aRapoport, David1 aResnick, Helaine, E1 aSanders, Mark1 aSmith, Philip uhttps://chs-nhlbi.org/node/784