Sleep position, patient comfort, and technical performance with two established procedures for home sleep testing

Purpose In patients with a high pre-test probability of suffering from obstructive sleep apnea (OSA), (cardio)-respiratory polygraphy (RP; level 3) is commonly used for home sleep testing (HST); however, testing based on peripheral arterial tonometry (PAT) is increasingly recognized as an alternative method. The aim of the study was to compare sleep position, patients’ comfort, and technical failure rates of HST with RP and PAT in patients with suspected OSA. Methods Sleep position, patients’ comfort, and technical failure rates of RP and PAT were compared in 56 patients receiving two nights of HST with either RP or PAT in a randomized fashion. Results Time in supine position with PAT was significantly lower (173.7±88 min) compared to RP (181.7±103.7 min; p < 0.001), although the absolute mean difference was not clinically significant. Patients reported to sleep better, feeling less disturbed when falling asleep, losing less sensors, and fewer nightly awakenings with PAT, but experienced more pain at the side of the finger probe. Forty-five out of 56 patients (80%) rated PAT as being the superior sleep test and 49 out of 56 (88%) would prefer PAT for further investigations (p<0.001). PAT testing was associated with less technical failures. Conclusion The results demonstrate that HST with PAT leads to less time in supine sleep positioning, which may be clinically relevant in selected patients. Moreover, PAT is associated with less technical failures and is perceived with less discomfort during testing and a reduced number of nocturnal awakenings in patient self-reports.

0576 Variation in Night to Night Home Sleep Testing

Introduction Home sleep testing (HST) is becoming common in the evaluation of Obstructive Sleep Apnea (OSA). Studies confirmed good HST AHI correlations from different nights in a single patient. The following reviewed AHI and additional measures from HST’s. (Alice Night One)) Methods We collected data from 20 patients from two consecutive nights of HST’s. 5 F 15 M, means AGE 49 (sd 14) and BMI 36 (sd 8). Both studies had over 4 hours of good sleep and acceptable data. Measures include abs(Night 1- Night 2) of AHI (Diff.AHI), of mean EKG (Diff.EKG) mean time SaO2 less than 90% (Diff.SaO2). Results These results reproduced the strong correlation of AHI, Time SaO2 less than 90 %: and mean EKG between two nights, .96, .72, .87 respectively. There was a strong correlation between Diff.AHI and Diff.SaO2, .63 (p .003). There were weaker correlations between AHI and Time SaO2 less than 90% on Night 1, .67 and Night 2, .75. Linear regression: Diff.AHI on Age (p=.2), BMI (p = .9), and Diff.EKG (p=.4). Conclusion These results again validate the small degree of AHI variation in night to night HST. They confirm a small degree of variation in the mean EKG and Time SaO2 less than 90%. There is a high correlation between AHI and time SaO2 less than 90% as these variables are dependent and the fall in SaO2 is used to define an event, especially on the HST. The BMI did not explain variation in AHI, there is a low correlation between AHI and BMI. Age could be a factor in AHI variation; yet, this is highly speculative with an N = 20. The correlations between AHI and Time SaO2 less than 90% are likely to be due to the relative health of the subjects and small number of subjects. One night of good, greater than 4 hours HST may be sufficient. This study did not evaluate success in meeting these parameters with a single night of testing. Support Louis B Stokes VHA, Cleveland, OH

1207 Keep It Simple: Wireless Patches For Home Sleep Diagnostics

Introduction Despite growing use of home sleep testing for the diagnosis of obstructive sleep apnea (OSA), there are significant barriers including limited availability, high cost, and complex wires making it difficult for patients to use on their own. The objective of this study was to evaluate a new flexible, thin, and wireless adhesive patch (proprietor sensors, TatchSleep Pro [TSP]) for the detection of OSA and compare the validity to overnight polysomnography (PSG). The TSP transmits data wirelessly to a smartphone app which in turn uploads the data to a cloud server. Data is presented to a sleep professional via a dedicated interface to score and analyze the results. Methods Patients (n=9; mean age=47 (SD=10); mean BMI=33 (SD=6.6); 4 males) undergoing a PSG evaluation for OSA also wore 2 TSP patches applied on the chest and abdomen. The TSP patches detected respiratory effort, derived airflow, derived pressure, body position and movement. Two sets of respiratory data (with common SpO2 and heartrate as a reference from PSG) were created, one from PSG and one from the TSP. The data were then scored by a certified sleep technician, blinded to the conditions. Linear regression analyses were used to compare the two derived apnea-hypopnea indices (AHI). In the morning, all participants were asked about their experience using the TSP. The study was approved by the Western IRB. Results There was a significant correlation for AHI between the TSP and PSG (R2= 0.94; p&lt;0.01). All participants found the TSP comfortable to wear and indicated that removing the patches was ‘easy’ or ‘very easy,’ Conclusion These preliminary results suggest the wireless TSP may be an effective, cost-efficient way to evaluate OSA. Despite small sample, results show promise as a new innovative product for home sleep testing. Support Supported by Tatch Inc.