Evaluation of First Night Effect using Ambulatory Monitoring and Automatic Sleep Stage Analysis

Sharpley, A L; Solomon, Rekha; Cowen, Philip J.

doi:10.1093/sleep/11.3.273

Cited by 92 publications

(43 citation statements)

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“…In such cases, home recording affords improved comfort and familiarity during studies conducted at appropriate sleep-wake cycle times, with first-night effects minimized. In contrast, other patients may worry more if they are studied without medical supervision [27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Influence of setting on unattended respiratory monitoring in the sleep apnoea/hypopnoea syndrome

Lloberes¹,

Sampol²,

Lévy³

et al. 2001

Eur Respir J

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The high demand for full polysomnography and the better quality of sleep at home are the main reasons for performing home sleep studies. Home respiratory monitoring has been evaluated in several studies, but the influence of setting on the results of unattended respiratory monitoring has not been assessed to date.Unattended monitoring of respiratory variables at home and in the sleep laboratory was conducted in 35 consecutive patients with suspected sleep apnoea/hypopnoea syndrome. Respiratory variables during sleep, rate of successful studies and patient preference were compared.The data acquisition failure rate was 2.8% in the sleep laboratory and 5.7% at home. The mean difference between apnoea/hypopnoea indices (AHI) obtained from home and laboratory studies was -0.21¡8 (95% confidence interval 3.27-2.84). Using the method comparison approach of Bland and Altman, the limits of agreement of the mean difference between AHI home and AHI laboratory were -16.7 and 17.1. No difference was observed between the studies in time spent in different body positions. When patients were asked where they would prefer to repeat the sleep study, 53% replied at home, 28% in hospital and 19% showed no preference.It was concluded that the setting of unattended respiratory monitoring (home or sleep laboratory) influences neither the number of valid studies nor the results of the respiratory parameters measured; most patients, however, preferred home studies.

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Section: Discussionmentioning

confidence: 99%

Influence of setting on unattended respiratory monitoring in the sleep apnoea/hypopnoea syndrome

Lloberes¹,

Sampol²,

Lévy³

et al. 2001

Eur Respir J

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“…15 This is important as home PM may be most relevant to patient's "true disease burden" and where "noise" such as variability due to first-night effect is minimized. [16][17][18] We hypothesized that night-to-night variability assessed in patients' usual sleep environment (by home PM) would be higher in mild OSA and in patients without signs and symptoms of sleepiness (due to lower chronic exposure to intermittent hypoxia and sleep fragmentation). We prospectively examined night-to-night variability in AHI with home PM (AHI PM ) over 2 to 8 nights in a sample of middle-aged newly diagnosed OSA patients.…”

Section: Brief Summarymentioning

confidence: 99%

Short-Term Variability in Apnea-Hypopnea Index during Extended Home Portable Monitoring

Prasad

Usmani

Steffen

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Apnea-hypopnea index (AHI) is the primary measure used to confirm a diagnosis of obstructive sleep apnea (OSA). However, there may be significant night-to-night variability (NNV) in AHI, limiting the value of AHI in clinical decision-making related to OSA management. We examined shortterm NNV in AHI and its predictors during home portable monitoring (PM). Methods: Single center prospective observational study of patients (n = 84) with newly diagnosed OSA by polysomnography (PSG) AHI ≥ 5/h. All participants underwent 2 to 8 consecutive nights of PM. Results: Participants (n = 84) were middle-aged (47 ± 8.3 y, mean ± standard deviation; SD), including 28 women, with mean AHI on baseline PSG (AHI PSG ) of 30.1 ± 31.8. Mean AHI on PM (AHI PM ) was 27.4 ± 23.7. Intraclass correlation coefficient (ICC) for AHI PM in the entire sample was 0.73 (95% CI 0.66-0.8), indicating that 27% of the variability in AHI PM was due to intra-individual factors. Mild severity of OSA, defined by AHI PSG 5-15/h, was associated with higher NNV (likelihood ratio, −0.4 ± 0.14; p = 0.006) and absence of comorbidity showed a trend towards higher NNV (−0.54 ± 0.27, p = 0.05) on AHI PM . Conclusions:The intraindividual short-term NNV in AHI PM is higher in mild versus moderately severe OSA, even in the home setting, where first-night effect is not expected. Larger studies of NNV focused on patients with mild OSA are needed to identify characteristics that predict need and timing for repeated diagnostic testing and treatment. Commentary: A commentary on this article appears in this issue on page 787.

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“…It often, but not always, shows less sleep continuity, as well as an increased sleep latency (74)(75)(76)(77)(78)(79)(80). Using an interindividual approach, Drake et al (81) developed an index for sleep vulnerability to stress and showed that those who reported habitual sensitivity to stress had a lower first-night sleep efficiency and longer sleep latency than those with low scores.…”

Section: Stress and Polysomnographymentioning

confidence: 99%

Psychosocial stress and impaired sleep

Åkerstedt¹

2006

Scand J Work Environ Health

473

380

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Evaluation of First Night Effect using Ambulatory Monitoring and Automatic Sleep Stage Analysis

Cited by 92 publications

References 0 publications

Influence of setting on unattended respiratory monitoring in the sleep apnoea/hypopnoea syndrome

Influence of setting on unattended respiratory monitoring in the sleep apnoea/hypopnoea syndrome

Short-Term Variability in Apnea-Hypopnea Index during Extended Home Portable Monitoring

Psychosocial stress and impaired sleep

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