Evidence map›Paper›PMID 30397738›Full record

ArticleSleep & breathing = Schlaf & Atmung2019

The utility of current criteria for split-night polysomnography for predicting CPAP eligibility.

Nashwa Wahba, Syed Sayeeduddin, Montserrat Diaz-Abad, Steven M Scharf

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Article in Sleep & breathing = Schlaf & Atmung, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Nashwa WahbaSleep Disorders Center, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 100 N. Greene Street, 2nd Floor, Baltimore, MD, 21201, USA.
Syed SayeeduddinSleep Disorders Center, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 100 N. Greene Street, 2nd Floor, Baltimore, MD, 21201, USA.
Montserrat Diaz-AbadSleep Disorders Center, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 100 N. Greene Street, 2nd Floor, Baltimore, MD, 21201, USA.
Steven M ScharfSleep Disorders Center, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 100 N. Greene Street, 2nd Floor, Baltimore, MD, 21201, USA. sscharf@som.umaryland.edu.ORCID http://orcid.org/0000-0002-2870-9711

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTraditionally, evaluation of obstructive sleep apnea (OSA) has consisted of a diagnostic polysomnogram (PSG), followed by a continuous positive pressure (CPAP) titration. However, to reduce costs, many third-party payers mandate performance of split-night studies (SPL), combining diagnostic and CPAP titration testing. We ascertained the utility of performing SPL for diagnosis and treatment of OSA.

methodsWe reviewed the PSG records of 200 patients suspected of having OSA. Using both American Academy of Sleep Medicine (AASM) and Medicare (CMS) criteria for scoring, we calculated the sensitivity, specificity, positive (PPV), and negative predictive value (NPV) of the AHI in the first 2 h of sleep for predicting an overall AHI > 15.

resultsFor predicting an overall AHI > 15, the sensitivity, specificity, PPV, and NPV of an AHI (AASM criteria) > 40 in the first 2 h were respectively: 0.304, 1.000, 1.000, and 0.335. For an AHI > 20 in the first 2 h, the corresponding values were 0.770, 0.962, 0.983, and 0.595. Corresponding values using CMS criteria were 0.347, 1.0, 1.0, and 0.6 for AHI > 40, and 0.693, 0.99, 0.986, and 0.76 for AHI > 20, respectively.

conclusionFor justification of CPAP (overall AHI > 15), the sensitivity is slightly lower when using an AHI > 40 vs AHI > 20, but the specificity and PPV are much higher. Using AHI > 20 as criteria for SPL as opposed to the guideline criteria of AHI > 40 may be more effective in obtaining CPAP for patients with moderate to severe OSA.

Indexed as

Continuous Positive Airway PressureHumansMonitoring, AmbulatoryPolysomnographySleep Apnea, ObstructiveApnea-hypopnea indexCPAP titrationObstructive sleep apneaPolysomnographySplit night studies

Identifiers

PMID30397738

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.