ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2017
Potential Underestimation of Sleep Apnea Severity by At-Home Kits: Rescoring In-Laboratory Polysomnography Without Sleep Staging.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 1 of them a synthesis that pooled it.
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Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Obstructive sleep apnea in patients with head and neck cancer: a systematic review.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Pooled it
- Mandibular movement monitor provides faster, yet accurate diagnosis for obstructive sleep apnoea: A randomised controlled study.Clinical medicine (London, England) · 2024Trial
- Performance Investigation of Somfit Sleep Staging Algorithm.Nature and science of sleep · 2024Trial
- Home Sleep Apnea Testing is a Feasible and Accurate Method to Diagnose Obstructive Sleep Apnea in Stroke Patients During In-Hospital Rehabilitation.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2018Trial
- Sarcopenia and Physical Function in Obstructive Sleep Apnea: A Single-Centre Cross-Sectional Study (The SOSA Study).The clinical respiratory journal · 2026Article
- Modified scoring criteria to improve the accuracy of the home sleep apnea test.Sleep & breathing = Schlaf & Atmung · 2026Article
- Seasonal variation in sleep apnea and other sleep parameters from diagnostic polysomnography data, 2003-2024.Communications health · 2026Article
- Failure to complete diagnostic testing in patients with suspected obstructive sleep apnoea and inconclusive home sleep apnoea test.Sleep & breathing = Schlaf & Atmung · 2025Article
- Quantifying the sources of discrepancy between total recording time and total sleep time in home sleep apnea testing: insights from home-based polysomnography.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Observational
- Wearable Artificial Intelligence for Sleep Disorders: Scoping Review.Journal of medical Internet research · 2025Article
- Evaluating Somfit's pulse arterial tonometry for detection of obstructive sleep apnoea.Sleep and biological rhythms · 2025Article
- Diagnostic Accuracy of the Alice NightOne Single-Belt Monitor for Obstructive Sleep Apnea and Reliability of Wireless Data Transfer.Nature and science of sleep · 2025Article
- OSA diagnosis goes wearable: are the latest devices ready to shine?Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Review
- Overnight Sleep Staging Using Chest-Worn Accelerometry.Sensors (Basel, Switzerland) · 2024Article
- The impact of study type and sleep measurement on oxygen desaturation index calculation.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- High prevalence of obstructive sleep apnea in a surgical aortic valve replacement cohort: an observational study.Sleep advances : a journal of the Sleep Research Society · 2024Article
- Respiratory event index underestimates severity of sleep apnea compared to apnea-hypopnea index.Sleep advances : a journal of the Sleep Research Society · 2024Article
- The prevalence of treatment-emergent central sleep apnea with mandibular advancement device therapy.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Article
- Overview of the hypnodensity approach to scoring sleep for polysomnography and home sleep testing.Frontiers in sleep · 2023Review
- Autonomic arousal detection and cardio-respiratory sleep staging improve the accuracy of home sleep apnea tests.Frontiers in physiology · 2023Article
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2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesHome sleep apnea testing (HSAT) is increasingly available for diagnosing obstructive sleep apnea (OSA). One key limitation of most HSAT involves the lack of sleep staging, such that the respiratory event index is calculated using the total recording time (TRT) rather than total sleep time (TST).
methodsWe performed a retrospective analysis of n = 838 diagnostic polysomnography (PSG) nights from our center; n = 444 with OSA (4% rule, apneahypopnea index (AHI) ≥ 5), and n = 394 with AHI < 5. We recalculated the AHI using time in bed (TIB) instead of TST, to assess the predicted underestimation risk of OSA severity.
resultsOf all the patients with OSA, 26.4% would be reclassified as having less severe or no OSA after recalculating the AHI using TIB rather than TST. Of the n = 275 with mild OSA, 18.5% would be reclassified as not having OSA. The risk of underestimation was higher in those with moderate or severe OSA. Of the n = 119 moderate OSA cases, 40.3% would be reclassified as mild, and of the n = 50 severe OSA cases, 36.0% would be reclassified as moderate. Age strongly correlated with the degree of underestimation of the AHI, because age was significantly correlated with time awake during PSG.
conclusionsThe risk of sleep apnea underestimation is predicted to be substantial in a tertiary sleep center population. Phenotyping errors included risk of falsely negative results (from mild to normal), as well as category errors: moderate or severe moving to mild or moderate severity, respectively. Clinicians should recognize this underestimation limitation, which directly affects diagnostic phenotyping and thus therapeutic decisions. COMMENTARY: A commentary on this article appears in this issue on page 531.
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