Polysomnography Performed in the Unattended Home Versus the Attended Laboratory Setting—Sleep Heart Health Study Methodology

Iber, Conrad; Redline, Susan; Gilpin, Adele M. K.; Quan, Stuart F.; Zhang, Lin; Gottlieb, Daniel J.; Rapoport, David M.; Resnick, Helaine E.; Sanders, Mark H.; Smith, Philip L.

doi:10.1093/sleep/27.3.536

Cited by 170 publications

(123 citation statements)

References 11 publications

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“…Elimination of the subset of subjects with a short total sleep time did not influence the principal results of the study. This procedure may be argued to have changed the validity of the sleep recordings, however, many studies have shown the similarity of in-lab PSG and home PSG [44,45]. A considerable proportion of the cases in this study were taking antihypertensive medications.…”

Section: Discussionmentioning

confidence: 82%

Hypertension prevalence in obstructive sleep apnoea and sex: a population-based case–control study

Hedner

Bengtsson-Boström

Peker³

et al. 2006

Eur Respir J

134

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Obstructive sleep apnoea (OSA) is a recognised risk factor for hypertension (HT). The current authors investigated confounders of this association in a sex-balanced communitybased sample of patients with HT (n5161) from the Skaraborg Hypertension and Diabetes Project (n51,149) and normotensive controls (n5183) from an age and sex stratified community-based population sample (n51,109). All participants underwent ambulatory home polysomnography.Severe OSA (apnoea-plus-hypopnoea index (AHI) o30 events?h -1) was found in 47 and 25% of hypertensive and normotensive males, respectively. The corresponding numbers in females were 26 and 24%, respectively. The odds ratio (OR) for HT increased across AHI tertiles from 1.0 to 2.1 (95% confidence interval: 0.9-4.5) and 1.0 to 3.7 (95% CI: 1.7-8.2) in males, but not in females where the OR increased from 1.0 to 1.8 (95% CI: 0.8-3.9) and 1.0 to 1.6 (95% CI: 0.7-3.5). Regression analysis correcting for age, body mass index (or waist-hip ratio) and smoking did not eliminate the association between OSA and HT in males.The present data suggest that obstructive sleep apnoea is highly prevalent in both the general population and in patients with known hypertension. The contribution of obstructive sleep apnoea to hypertension risk may be sex dependent and higher in males than in females.

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Section: Discussionmentioning

confidence: 82%

Hypertension prevalence in obstructive sleep apnoea and sex: a population-based case–control study

Hedner

Bengtsson-Boström

Peker³

et al. 2006

Eur Respir J

134

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“…The current authors had a comparatively low signal failure rate, possibly due to the limited mobility of the present patient group and sensor displacement being lessened by mask and headgear use during the studies. Home polysomnography appears to have no ''first night effect'' [24], and the evidence suggests that the two scenarios can produce comparable results in respiratory and sleep data [21,25]. In the current study, the effect of study location was minimised by limiting patients to the same location for both polysomnographic studies.…”

Section: Limitations Of the Studymentioning

confidence: 76%

Autotitratingversusstandard noninvasive ventilation: a randomised crossover trial

Jaye¹,

Chatwin²,

Dayer³

et al. 2009

Eur Respir J

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The aim of the present study was to compare the efficacy of automatic titration of noninvasive ventilation (NIV) with conventional NIV in stable neuromuscular and chest wall disorder patients established on long-term ventilatory support.In total, 20 neuromuscular and chest wall disease patients with nocturnal hypoventilation treated with long-term NIV completed a randomised crossover trial comparing two noninvasive pressure support ventilators: a standard bilevel ventilator (VPAP III) and a novel autotitrating bilevel ventilator (AutoVPAP). Baseline physiological measurements, overnight polysomnography and Holter monitoring were repeated at the end of each 1-month treatment period.Nocturnal oxygenation was comparable between the autotitrating device and standard ventilator, as were sleep efficiency, arousals and heart rate variability. However, there was a small significant increase in mean overnight transcutaneous carbon dioxide tension (median (interquartile range) 7.2 (6.7-7.7) versus 6.7 (6.1-7.0) kPa) and a decrease in percentage stage 1 sleep (mean¡SD 16¡9 versus 19¡10%) on autotitrating NIV compared with conventional NIV.Autotitrating noninvasive ventilation using AutoVPAP produced comparable control of nocturnal oxygenation to standard nonivasive ventilation, without compromising sleep quality in stable neuromuscular and chest wall disease patients requiring long-term ventilatory support for nocturnal hypoventilation.

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“…For the present analysis, AHI was obtained with the use of apneas and hypopneas associated with at least 4% oxyhemoglobin desaturation. The intraclass correlation of AHI was 0.75 between unattended home and attended laboratory settings 27 and 0.80 for night-to-night variability in the unattended home setting. 28 The interscorer reliability for scoring AHI in the SHHS was also excellent, with an intraclass correlation of 0.99.…”

Section: Polysomnographymentioning

confidence: 89%

Sleep-Disordered Breathing

Lavie¹,

Vishnevsky²,

Lavie³

et al. 2013

Encyclopedia of Behavioral Medicine

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Background-Whether sleep-disordered breathing (SDB) is a risk factor for left ventricular (LV) hypertrophy and dysfunction is controversial. We assessed the relation of SDB to LV morphology and systolic function in a community-based sample of middle-aged and older adults. Methods and Results-The present study was a cross-sectional observational study of 2058 Sleep Heart Health Study participants (mean age 65Ϯ12 years; 58% women; 44% ethnic minorities) who had technically adequate echocardiograms. A polysomnographically derived apnea-hypopnea index (AHI) and hypoxemia index (percent of sleep time with oxyhemoglobin saturation Ͻ90%) were used to quantify SDB severity. LV mass index was significantly associated with both AHI and hypoxemia index after adjustment for age, sex, ethnicity, study site, body mass index, current and prior smoking, alcohol consumption, systolic blood pressure, antihypertensive medication use, diabetes mellitus, and prevalent myocardial infarction. Adjusted LV mass index was 41.3 (SD 9.90) g/m 2.7 in participants with AHI Ͻ5 (nϭ957) and 44.1 (SD 9.90) g/m 2.7 in participants with AHI Ն30 (nϭ84) events per hour. Compared with participants with AHI Ͻ5, those with AHI Ն30 had an adjusted odds ratio of 1.78 (95% confidence interval 1.14 to 2.79) for LV hypertrophy. A higher AHI and higher hypoxemia index were also associated with larger LV diastolic dimension and lower LV ejection fraction, with a trend toward lower LV fractional shortening. LV wall thickness was significantly associated with the hypoxemia index but not with AHI. Left atrial diameter was not associated with either SDB measure. Conclusions-In

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Polysomnography Performed in the Unattended Home Versus the Attended Laboratory Setting—Sleep Heart Health Study Methodology

Cited by 170 publications

References 11 publications

Hypertension prevalence in obstructive sleep apnoea and sex: a population-based case–control study

Hypertension prevalence in obstructive sleep apnoea and sex: a population-based case–control study

Autotitratingversusstandard noninvasive ventilation: a randomised crossover trial

Sleep-Disordered Breathing

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