Split Night versus Full Night Polysomnography in Obstructive Sleep Apnoea Syndrome: A Retrospective Study
Published: April 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/61170.17690
Rohit Kumar, Siddharth Raj Yadav, Amit Kumar, Manas Mengar, Nitesh Gupta, Pranavish, Shweta Gupta, Divyendu Sharma
1. Assistant Professor, Department of Pulmonary Medicine and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
2. Assistant Professor, Department of Pulmonary Medicine and Sleep Medicine, Vallabhbhai Patel Chest Institute, Delhi University, New Delhi, India.
3. Assistant Professor, Department of Pulmonary Medicine and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
4. Consultant, Department of Pulmonary Medicine and Sleep Medicine, Jupiter Hospital, Mumbai, India.
5. Assistant Professor, Department of Pulmonary Medicine and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
6. Assistant Professor, Department of Pulmonary Medicine and Sleep Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
7. Assistant Professor, Department of TB and Chest, Baba Sahib Ambedkar Medical College, New Delhi, India.
8. Senior Resident, Department of Pulmonary Medicine and Sleep Medicine, Vallabhbhai Patel Chest Institute, Delhi University, New Delhi,
Correspondence
Rohit Kumar,
Assistant Professor, Department of Pulmonary Medicine and Sleep Medicine, Room No. 614, Sixth Floor, SSB VMMC and Safdarjung Hospital, New Delhi-110029, India.
E-mail: dr.rohitkumar@mail.com
Introduction: Obstructive Sleep Apnoea (OSA) is traditionally evaluated using a diagnostic Polysomnography (PSG) which is then followed by a PSG with Continuous Positive Airway Pressure (CPAP) titration. Split Night PSG (SN-PSG) includes the diagnostic and titration study in a single night. Split Night PSG is a better technique however, the requirements for CPAP titration are too strict.
Aim: To assess the accuracy of different duration of split night compared to a Full Night PSG (FN-PSG) in OSA Syndrome.
Materials and Methods: A retrospective observational study was performed in the Department of Pulmonary Medicine at VMMC and Safdarjung Hospital, New Delhi, India, from January 2019 to May 2019. Apnoea-Hypopnea Index (AHI) was assessed at the 1 hour, 2 hour, 3 hour and 4 hour from analysis of SN-PSG data obtained from FN-PSG. Using the Area Under Receiver Operating Characteristic (AUROC) curve, it was compared to the FN-PSG. Calculations were made to validate the diagnosis by a 2 hour PSG using different AHI cut-off points (5/hour to 15/hour).
Results: Data from 20 PSG recordings were processed. A stronger correlation of FN-AHI was demonstrated with AHI at 2 hour (p-value <0.0001) (r value=0.902). At 2 hours of study, with an AHI cut-off of 5 hour, the sensitivity and specificity was 92.9% and 83.3%, respectively. The Positive Predictive Value (PPV) was 92.9% and Negative Predictive Value (NPV) was 83.3% (AUROC=0.976; p-value=0.001). At 2 hours, AHI cut-off of 15 hour, the sensitivity and specificity was 71.4% and 100%, respectively. The PPV was 100% and NPV was 86.7% (AUROC=1.000; p-value <0.0001).
Conclusion: Split night PSG is effective for diagnosing severe OSA. A lower cut-off of AHI may be used to qualify patients for CPAP titration.
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