Nightly Variability in the Indices of Sleep-Disordered Breathing in Men Being Evaluated for Impotence With Consecutive Night Polysomnograms

Night-to-night Variability in Obstructive Sleep Apnea Severity: Relationship to Overnight Rostral Fluid Shift

“…[1][2][3][4] We found that 35% of patients had a change in AHI between PSGs of greater than 10, which is comparable to the only other study assessing AHI variability over non-consecutive nights, in which 30% of patients had a change in AHI of greater than 10 between PSGs performed one month apart.…”

“…Previous studies found a change in the frequency of apneas and hypopneas per hour of sleep (apnea-hypopnea index, AHI) greater than 10 in 18% to 65% of patients undergoing polysomnograms (PSGs) on consecutive nights or one month apart. [1][2][3][4] Furthermore, in one study, 50% of patients undergoing consecutive night PSGs met criteria for OSA diagnosis (AHI ≥ 10) on one PSG but not on the other. 3 Few studies have examined the reasons for this AHI variability.…”

“…[1][2][3][4] Furthermore, in one study, 50% of patients undergoing consecutive night PSGs met criteria for OSA diagnosis (AHI ≥ 10) on one PSG but not on the other. 3 Few studies have examined the reasons for this AHI variability. While one study found increased variability in patients with higher AHIs, another did not.…”

The SLEEP GOAL as a success criteria in obstructive sleep apnea therapy

“…There is a mountain of evidence showing how the AHI can vary from night to night, vary from laboratory to laboratory, from various nasal thermistor to pressure transducers, and AHI can vary based on the different definitions of hypopnea used in different laboratories and software [6][7][8][9][10][11][12][13][14]. The contemporary reliance on AHI as generally the only outcome measure assessed in research programs is not in line with many other aspects of medicine that are becoming patient centered as opposed to test centered [6][7][8][9][10][11][12][13][14].According to the surgical literature on OSA treatment, Sher's success criteria of 50 % reduction in AHI and an AHI less than 20 tend to be the benchmark for success [15]. However, this archaic concept was based entirely on an arbitrary AHI number that did not stratify the patients by likelihood of surgical success.…”

“…Moreover, recent evidence has shown significant discordance between the levels of AHI used to denote outcomes of therapy and real world clinical outcomes such as QOL, patient perception of disease, cardiovascular measures, disease burden and/or survival [1][2][3][4][5]. There is a mountain of evidence showing how the AHI can vary from night to night, vary from laboratory to laboratory, from various nasal thermistor to pressure transducers, and AHI can vary based on the different definitions of hypopnea used in different laboratories and software [6][7][8][9][10][11][12][13][14]. The contemporary reliance on AHI as generally the only outcome measure assessed in research programs is not in line with many other aspects of medicine that are becoming patient centered as opposed to test centered [6][7][8][9][10][11][12][13][14].…”