https://doi.org/10.4081/monaldi.2024.2945
Diagnostic accuracy of daytime polysomnography: a reappraisal during the COVID-19 era
Submitted: February 4, 2024
Accepted: February 14, 2024
Published: February 29, 2024
Accepted: February 14, 2024
Abstract Views: 369
PDF_EARLY VIEW: 165
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Level I conventional polysomnography (PSG), the gold standard for diagnosing obstructive sleep apnea (OSA), requires an overnight stay. This study evaluated the role of daytime PSG as an alternative diagnostic tool. A prospective cohort study was undertaken with consecutive patients with suspected OSA at a tertiary care sleep center. The primary objective was to evaluate the sensitivity and diagnostic accuracy of daytime PSG for diagnosing OSA. The secondary objective was to find out the factors associated with a falsely negative daytime PSG result. All individuals were subjected to level I daytime PSG, done in the sleep lab in the presence of an experienced sleep technician during the daytime from 12 PM to 4 PM. Out of 162 patients, 105 underwent daytime PSG. OSA was diagnosed on daytime PSG in 86.7 out of the 19 remaining patients refused a repeat PSG study. Out of the 12 individuals who underwent the nighttime PSG for confirmatory diagnosis, 10 were diagnosed as OSA (false negatives), and 2 were confirmed as not-OSA (true negatives). The sensitivity, diagnostic accuracy, and negative predictive value of daytime PSG were 89.58%, 89.80%, and 16.67%, respectively. The false negatives had a higher prevalence of mild OSA. Daytime PSG is sensitive in diagnosing OSA and can be considered in individuals with severe symptoms at centers with a high patient load or when the individual wishes to avoid a nighttime study. A negative result in daytime PSG must be followed by conventional overnight PSG for confirmatory diagnosis.
Lyons MM, Bhatt NY, Pack AI, et al. Global burden of sleep-disordered breathing and its implications. Respirology 2020;25:690-702.
DOI: https://doi.org/10.1111/resp.13838
Suri TM, Ghosh T, Mittal S, et al. Systematic review and meta-analysis of the prevalence of obstructive sleep apnea in Indian adults. Sleep Med Rev 2023;71:101829.
DOI: https://doi.org/10.1016/j.smrv.2023.101829
Sharma SK, Katoch VM, Mohan A, et al. Consensus and evidence-based Indian initiative on obstructive sleep apnea guidelines 2014 (first edition). Lung India 2015;32:422-34.
DOI: https://doi.org/10.4103/0970-2113.159677
Rosen IM, Kirsch DB, Carden KA, et al. Clinical use of a home sleep apnea test: an updated American Academy of Sleep Medicine position statement. J Clin Sleep Med 2018;14:2075-7.
DOI: https://doi.org/10.5664/jcsm.7540
Jensen MH, Dalgaard F, Laub RR, et al. Protocol for detecting unrecognized sleep apnea in patients with atrial fibrillation by a home-monitoring device: the DAN-APNO study. BMC Cardiovasc Disord 2022;22:6.
DOI: https://doi.org/10.1186/s12872-021-02453-0
Gupta N, Ish P, Kumar R, et al. Evaluation of the clinical profile, laboratory parameters and outcome of two hundred COVID-19 patients from a tertiary centre in India. Monaldi Arch Chest Dis 2020;90.
DOI: https://doi.org/10.4081/monaldi.2020.1507
Ministry of Health and Family Welfare, Government of India. Enabling delivery of essential health services during the COVID 19 outbreak: guidance note. Available from: https://www.mohfw.gov.in/pdf/EssentialservicesduringCOVID19updated0411201.pdf. Accessed on: 24/09/2023.
World Health Organization. Maintaining essential health services: operational guidance for the COVID-19 context. 2020. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-essential_health_services-2020.2. Last accessed on: 24/09/2023.
Miyata S, Noda A, Nakata S, et al. Daytime polysomnography for early diagnosis and treatment of patients with suspected sleep-disordered breathing. Sleep Breath 2007;11:109-15.
DOI: https://doi.org/10.1007/s11325-006-0091-9
Mahakit P. A comparative study of two-hour daytime and overnight polysomnography in high risk snorers. J Med Assoc Thai 2012;95:S17-22.
Bosschieter PFN, Schoustra E, de Vries N, et al. Daytime polysomnography to perform titration for upper airway stimulation in patients with obstructive sleep apnea. Sleep Breath 2022;26:707-15.
DOI: https://doi.org/10.1007/s11325-021-02441-w
Van Keimpema AR, Rutgers SR, Strijers RL. The value of one hour daytime sleep recording in the diagnosis of the sleep apnoea syndrome. J Sleep Res 1993;2:257-9.
DOI: https://doi.org/10.1111/j.1365-2869.1993.tb00097.x
Aguirregomoscorta Urquijo JI, Menéndez Gastan I, Aparicio Abendaño S, et al. Nap polysomnography: sufficient grounds for initiating CPAP treatment?. Arch Bronconeumol 2001;37:302-6. [Article in Spanish].
DOI: https://doi.org/10.1016/S0300-2896(01)75099-5
Sergi M, Rizzi M, Greco M, et al. Validity of diurnal sleep recording performed by an ambulatory device in the diagnosis of obstructive sleep apnoea. Respir Med 1998;92:216-20.
DOI: https://doi.org/10.1016/S0954-6111(98)90098-1
Boynton G, Vahabzadeh A, Hammoud S, et al. Validation of the STOP-BANG questionnaire among patients referred for suspected obstructive sleep apnea. J Sleep Disord Treat Care 2013;2:10.
Feltner C, Wallace IF, Aymes S, et al. Screening for obstructive sleep apnea in adults: updated evidence report and systematic review for the US preventive services task force. JAMA 2022;328:1951-71.
DOI: https://doi.org/10.1001/jama.2022.18357
Mahismita P, Chandra OU, Dipti G, et al. Utility of combination of sleep questionnaires in predicting obstructive sleep apnea and its correlation with polysomnography. Indian J Sleep Med 2019;14:61-6.
DOI: https://doi.org/10.5005/jp-journals-10069-0046
Kapur VK, Auckley DH, Chowdhuri S, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine Clinical practice guideline. J Clin Sleep Med 2017;13:479-504.
DOI: https://doi.org/10.5664/jcsm.6506
Akoglu H. User's guide to sample size estimation in diagnostic accuracy studies. Turk J Emerg Med 2022;22:177-85.
DOI: https://doi.org/10.4103/2452-2473.357348
Mizuma H, Sonnenschein W, Meier-Ewert K. Diagnostic use of daytime polysomnography versus nocturnal polysomnography in sleep apnea syndrome. Psychiatry Clin Neurosci 1996;50:211-6.
DOI: https://doi.org/10.1111/j.1440-1819.1996.tb02744.x
Haraldsson PO, Carenfelt C, Knutsson E, et al. Preliminary report: validity of symptom analysis and daytime polysomnography in diagnosis of sleep apnea. Sleep 1992;15:261-3.
DOI: https://doi.org/10.1093/sleep/15.3.261
Yakar F, Yakar A, Sezer M, et al. Role of daytime polysomnography in the diagnosis of sleep apnea syndrome. Tuberk Toraks 2015;63:78-85.
DOI: https://doi.org/10.5578/tt.8538
Agnew Jr HW, Webb WB, Williams RL. The first night effect: an EEG study of sleep. Psychophysiology 1966;2:263-6.
DOI: https://doi.org/10.1111/j.1469-8986.1966.tb02650.x
Browman CP, Cartwright RD. The first-night effect on sleep and dreams. Biol Psychiatry 1980;15:809-12.
Curcia G, Ferrara M, Ciersiaooi A, et al. Paradoxes of the first-night effect: a quantitative analysis of antero-posterior EEG topography. Clin Neurophysiol 2004;115:1178-88.
DOI: https://doi.org/10.1016/j.clinph.2003.12.018
Toussaint M, Luthringer R, Schaltenbrand N, et al. First-night effect in normal subjects and psychiatric inpatients. Sleep 1995;18:463-9.
DOI: https://doi.org/10.1093/sleep/18.6.463
Ethics Approval
The research was approved by the institutional ethics committee (ESIPGIMSR-2022053).How to Cite
Patro, Mahismita, Nipun Malhotra, Dipti Gothi, Rahul Kumar, and Ganjam Yasasvini. 2024. “Diagnostic Accuracy of Daytime Polysomnography: A Reappraisal During the COVID-19 Era”. Monaldi Archives for Chest Disease, February. https://doi.org/10.4081/monaldi.2024.2945.
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Saroj Kumari Meena, Rajnish Gupta, Manmohan Puri, Existence and pattern of sleep-related breathing disorders in patients diagnosed with bronchial asthma , Monaldi Archives for Chest Disease: Early Access
- Elio Gorga, Marta Scodro, Francesca Valentini, Renzo D'Ortona, Mariachiara Arisi, Edoardo Sciatti, Ivano Bonadei, Valentina Regazzoni, Enrico Vizzardi, Marco Metra, Piergiacomo Calzavara Pinton, Echocardiographic evaluation of diastolic dysfunction in young and healthy patients with psoriasis: A case-control study , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- A. De Felice, S. Fuschillo, M. Martucci, E. De Angelis, G. Balzano, Euthyroid goitre and sleep apnea , Monaldi Archives for Chest Disease: Vol. 65 No. 1 (2006): Pulmonary series
- R. Sabato, P. Guido, F.G. Salerno, O. Resta, A. Spanevello, M.P. Foschino Barbaro, Airway inflammation in patients affected by obstructive sleep apnea , Monaldi Archives for Chest Disease: Vol. 65 No. 2 (2006): Pulmonary series
- Prakhar Agarwal, Kranti Garg, Varinder Saini, Isha Singh, Pulmonary rehabilitation: A novel adjunct in management of obstructive sleep apnea , Monaldi Archives for Chest Disease: Vol. 93 No. 1 (2023)
- Fiorella Devito, Annapaola Zito, Silvano Dragonieri, Pierluigi Carratù, Vitaliano N. Quaranta, Francesco Vitale, Nicola Quaranta, Francesco Panza, Giancarlo Logroscino, Matteo Cameli, Onofrio Resta, Marco Matteo Ciccone, Evaluation of endothelial function and cardiovascular risk in non-obese patients with slight degree of obstructive sleep apnea syndrome , Monaldi Archives for Chest Disease: Vol. 87 No. 3 (2017)
- Mansi Gupta, Pranav Ish, Shibdas Chakrabarti, Manas Kamal Sen, Prabhakar Mishra, Jagdish Chander Suri, Diagnostic accuracy and feasibility of portable sleep monitoring in patients with obstructive sleep apnea: Re-exploring the utility in the current COVID-19 pandemic , Monaldi Archives for Chest Disease: Vol. 92 No. 1 (2022)
- Carla Simonelli, Michele Vitacca, Beatrice Salvi, Manuela Saleri, Mara Paneroni, Comparison among three different follow-up models for obstructive sleep apnea syndrome patients: focus on the physiotherapist’s role , Monaldi Archives for Chest Disease: Early Access
- I. Hawrylkiewicz, P. Sliwinski, D. Górecka, R. Plywaczewski, J. Zielinski, Pulmonary haemodynamics in patients with OSAS or an overlap syndrome , Monaldi Archives for Chest Disease: Vol. 61 No. 3 (2004): Pulmonary series
- Anshul Mittal, Pranav Ish, Vidushi Rathi, Satish Kumar Kumawat, Shibdas Chakrabarti, JC Suri, Rehabilitation in obstructive sleep apnea: an ignored treatment adjunct , Monaldi Archives for Chest Disease: Early Access
You may also start an advanced similarity search for this article.
