This work was funded by the Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP) and Zerbini Foundation. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
Comparison of full versus short induced-sleep polysomnography for the diagnosis of sleep apnea †
Version of Record online: 25 APR 2011
Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 121, Issue 5, pages 1098–1103, May 2011
How to Cite
Gregório, M. G., Jacomelli, M., Inoue, D., Genta, P. R., de Figueiredo, A. C. and Lorenzi-Filho, G. (2011), Comparison of full versus short induced-sleep polysomnography for the diagnosis of sleep apnea . The Laryngoscope, 121: 1098–1103. doi: 10.1002/lary.21658
- Issue online: 25 APR 2011
- Version of Record online: 25 APR 2011
- Manuscript Accepted: 16 DEC 2010
- Manuscript Revised: 14 DEC 2010
- Manuscript Received: 5 NOV 2010
- sleep apnea syndromes;
- Level of Evidence: 2B
Polysomnography (PSG) is the gold-standard method for diagnosing obstructive sleep apnea (OSA). However, the gap between demand and capacity in performing PSG is a major health-care problem. We sought to validate a short day-time induced sleep for the diagnosis of OSA.
Prospective diagnostic method validation.
We studied 25 consecutive patients referred to the sleep laboratory and 15 healthy volunteers. All subjects were evaluated by means of full overnight PSG (Full-PSG) and short day-time induced-sleep PSG (Induced-PSG). Sleep was monitored during both procedures (Embla, 16 channels). Sleep was induced by slow intravenous drip infusion of midazolam.
The population studied (N = 40) was 60% male (mean age, 42 ± 10 years; body mass index, 29 ± 6.5 kg/m2). Sleep was successfully induced in all subjects, and no complications were observed (midazolam doses, 6.2 ± 3.8 mg; time of induced sleep 41.5 ± 18.9 minutes). The apnea-hypopnea index (AHI) and minimal oxygen saturation during Full-PSG versus Induced-PSG were similar: median AHI (with 25%–75% interquartile range) was 13 (3–35) events per hour versus 17 (4–36) events per hour, and median oxygen saturation was 84% (75–90) versus 85% (76–92); P =.89 and P =.53, respectively. The majority of the respiratory events during induced sleep were obstructive and similar to those observed during Full-PSG. AHI and lowest oxygen saturation during Induced-PSG correlated significantly with Full-PSG (r = 0.67 and r = 0.77, respectively). Sensitivity and specificity for the diagnosis of OSA (AHI > 15 events per hour) by Induced-PSG were 0.83 and 0.72, respectively.
Induced-PSG by midazolam during the day is safe and correlates with Full-PSG; it therefore is a promising alternative method in the diagnosis of OSA.