Unattended sleep studies in the diagnosis and reassessment of obstructive sleep apnoea

Merlin T, Liufu Z, Wang S
Record ID 32010001736
Original Title: Application 1130
Authors' results and conclusions: Safety- Only one uncontrolled case series provided weak evidence on the safety of unattended sleep studies for the diagnosis of obstructive sleep apnoea (OSA). Minor adverse events, such as skin redness and itching resulting from sleep device attachment, occurred in a small proportion of patients. In general, unattended sleep studies are considered safe diagnostic technologies. However, for theoretical safety reasons, caution should be used when considering unattended sleep studies for patients with neurocognitive disorders or for very young children. No comparative data regarding the safety of home-based sleep studies relative to an attended Level 1 sleep study were identified, however it is reasonable to assume that unattended Level 2, 3 and 4 sleep studies are no worse than attended Level 1 sleep studies in terms of safety. Effectiveness- Two uncontrolled case series of poor quality reported on the impact of unattended sleep studies on patients' health outcomes in a non-specialised unit setting. This evidence suggested that the diagnosis of OSA and subsequent treatment resulted in resolved symptoms, reduced apnoea events and an impact on comorbid hypertension. However, patients' quality of life did not appear to improve. Three controlled studies of moderate to poor quality, one randomised controlled trial and two prospective cohort studies were identified that reported on a change in health outcomes in patients with OSA, diagnosed with the aid of unattended sleep studies, in a referral setting. Level 2 and Level 4 sleep studies provided a benefit in terms of reducing excessive daytime sleepiness and controlling apnoea-hypopnoea episodes. Comparative evidence indicated that patients' health outcomes following Level 2 or Level 4 sleep studies were neither clinically nor statistically significantly different from those achieved following diagnosis with laboratory-based polysomnography (Level 1 study). No controlled studies provided direct evidence of the effectiveness of Level 3 sleep studies in a referral setting. Extremely weak evidence from a case report suggests that unattended sleep studies and subsequent OSA treatment may improve children's neuropsychologic functioning and reduce the occurrence of respiratory episodes. Higher level evidence on a change in children's health outcomes following the use of Level 2, 3 or 4 unattended sleep studies was not available.
Project Status: Completed
Year Published: 2010
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Australia
MeSH Terms
  • Humans
  • Sleep Apnea, Obstructive
  • obstructive sleep apnoea
  • unattended sleep studies
Organisation Name: Adelaide Health Technology Assessment
Contact Address: School of Public Health, Mail Drop 545, University of Adelaide, Adelaide SA 5005, AUSTRALIA, Tel: +61 8 8313 4617
Contact Name: ahta@adelaide.edu.au
Contact Email: ahta@adelaide.edu.au
Copyright: Adelaide Health Technology Assessment (AHTA)
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