02753nas a2200301 4500008004100000022001400041245007800055210006900133260001600202300001100218490000700229520192500236653001102161653002002172653003102192653002002223653002602243653001702269100001802286700001902304700001502323700001702338700001602355700001402371700001502385700001602400856003502416 1998 eng d a0161-810500aReliability of scoring respiratory disturbance indices and sleep staging.0 aReliability of scoring respiratory disturbance indices and sleep c1998 Nov 01 a749-570 v213 a

STUDY OBJECTIVES: Unattended, home-based polysomnography (PSG) is increasingly used in both research and clinical settings as an alternative to traditional laboratory-based studies, although the reliability of the scoring of these studies has not been described. The purpose of this study is to describe the reliability of the PSG scoring in the Sleep Heart Health Study (SHHS), a multicenter study of the relation between sleep-disordered breathing measured by unattended, in-home PSG using a portable sleep monitor, and cardiovascular outcomes.

DESIGN: The reliability of SHHS scorers was evaluated based on 20 randomly selected studies per scorer, assessing both interscorer and intrascorer reliability.

RESULTS: Both inter- and intrascorer comparisons on epoch-by-epoch sleep staging showed excellent reliability (kappa statistics >0.80), with stage 1 having the greatest discrepancies in scoring and stage 3/4 being the most reliably discriminated. The arousal index (number of arousals per hour of sleep) was moderately reliable, with an intraclass correlation (ICC) of 0.54. The scorers were highly reliable on various respiratory disturbance indices (RDIs), which incorporate an associated oxygen desaturation in the definition of respiratory events (2% to 5%) with or without the additional use of associated EEG arousal in the definition of respiratory events (ICC>0.90). When RDI was defined without considering oxygen desaturation or arousals to define respiratory events, the RDI was moderately reliable (ICC=0.74). The additional use of associated EEG arousals, but not oxygen desaturation, in defining respiratory events did little to increase the reliability of the RDI measure (ICC=0.77).

CONCLUSIONS: The SHHS achieved a high degree of intrascorer and interscorer reliability for the scoring of sleep stage and RDI in unattended in-home PSG studies.

10aHumans10aPolysomnography10aReproducibility of Results10aResearch Design10aSleep Apnea Syndromes10aSleep Stages1 aWhitney, C, W1 aGottlieb, D, J1 aRedline, S1 aNorman, R, G1 aDodge, R, R1 aShahar, E1 aSurovec, S1 aNieto, F, J uhttps://chs-nhlbi.org/node/643