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Polysomnography performed in the unattended home versus the attended laboratory setting--Sleep Heart Health Study methodology.

TitlePolysomnography performed in the unattended home versus the attended laboratory setting--Sleep Heart Health Study methodology.
Publication TypeJournal Article
Year of Publication2004
AuthorsIber, C, Redline, S, Gilpin, AMKaplan, Quan, SF, Zhang, L, Gottlieb, DJ, Rapoport, D, Resnick, HE, Sanders, M, Smith, P
JournalSleep
Volume27
Issue3
Pagination536-40
Date Published2004 May 01
ISSN0161-8105
KeywordsAdult, Aged, Body Mass Index, Clinical Laboratory Techniques, Cohort Studies, Health Status, Home Care Services, Humans, Middle Aged, Polysomnography, Sleep Apnea Syndromes, Sleep, REM
Abstract<p><b>STUDY OBJECTIVE: </b>To compare polysomnographic recordings obtained in the home and laboratory setting.</p><p><b>DESIGN AND SETTING: </b>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.</p><p><b>PARTICIPANTS: </b>64 of 76 non-SHHS participants recruited from 7 SHHS field sites who had both a laboratory and home polysomnogram meeting acceptable quality criteria.</p><p><b>MEASUREMENTS AND RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p>
DOI10.1093/sleep/27.3.536
Alternate JournalSleep
PubMed ID15164911
Grant ListU01HL53937 / HL / NHLBI NIH HHS / United States
U01HL64360 / HL / NHLBI NIH HHS / United States
U01HL53938 / HL / NHLBI NIH HHS / United States
U01-HL53934 / HL / NHLBI NIH HHS / United States
U01 HL053938 / HL / NHLBI NIH HHS / United States
U01HL63429 / HL / NHLBI NIH HHS / United States
U01HL53931 / HL / NHLBI NIH HHS / United States
U01HL53941 / HL / NHLBI NIH HHS / United States
U01HL53916 / HL / NHLBI NIH HHS / United States
U01HL63463 / HL / NHLBI NIH HHS / United States