ArticleChest2020
Variability and Misclassification of Sleep Apnea Severity Based on Multi-Night Testing.
Article in Chest, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 1 of them a synthesis that pooled it.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
74 citing papers in PubMed, 1 synthesis or guideline pooled it, 109 citations in OpenAlex.
- Utility of Belun Ring platform for the diagnosis of obstructive sleep apnea: a systematic review and meta-analysis.Sleep & breathing = Schlaf & Atmung · 2025Pooled it
- Tirzepatide on obstructive sleep apnea-related cardiometabolic risk: secondary outcomes of the SURMOUNT-OSA randomized trial.Nature medicine · 2026Trial
- Long-term night-to-night variability of sleep-disordered breathing using a radar-based home sleep apnea test: a prospective cohort study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Trial
- A new wearable diagnostic home sleep testing platform: comparison with available systems and benefits of multinight assessments.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Trial
- [A long-term ischemic stroke risk score model in patients aged 60 years and older with obstructive sleep apnea: a multicenter prospective cohort study].Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2022Trial
- Validation of the Withings Sleep Analyzer, an under-the-mattress device for the detection of moderate-severe sleep apnea syndrome.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Trial
- Broadband wearable acoustic sensing for continuous cardiopulmonary monitoring.Microsystems & nanoengineering · 2026Article
- New Obstructive Sleep Apnoea Multi-Night Diagnostic Devices. Is a Single Night of Measurement Now Considered Enough?Respirology (Carlton, Vic.) · 2026Article
- Zero burden multi night monitoring with AI enabled technology reduces obstructive sleep apnea misdiagnosis.NPJ digital medicine · 2026Article
- Article
- A novel, wearable, in-ear EEG technology to assess sleep and daytime sleepiness.Bioelectronic medicine · 2026Article
- Pediatric OSA-Spectrum of the Disease and Opportunities for Personalized Interventions.Journal of personalized medicine · 2026Review
- "Phenotyping obstructive sleep apnea: a pathway to precision medicine".Sleep & breathing = Schlaf & Atmung · 2026Review
- Validation of an artificial intelligence based single-channel photoplethysmography home sleep apnea test.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- Modified scoring criteria to improve the accuracy of the home sleep apnea test.Sleep & breathing = Schlaf & Atmung · 2026Article
- Steam-assisted respiratory muscle training may improve sleep quality in mild-to-moderate obstructive sleep apnea: a pilot polysomnography study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- Clinical Validation of Artificial Intelligence Algorithms for the Diagnosis of Adult Obstructive Sleep Apnea and Sleep Staging From Oximetry and Photoplethysmography-SleepAI.Journal of sleep research · 2026Article
- Review
- Misperception of supine sleep in the sleep laboratory: a retrospective review of self-reported versus polysomnography-measured sleep position.Sleep & breathing = Schlaf & Atmung · 2026Article
- Exploring nightly variability in sleep apnea and changes in severity classification with multi night sleep testing in a population based cohort of young children.Frontiers in sleep · 2026Article
14 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPortable monitoring is a convenient means for diagnosing sleep apnea. However, data on whether one night of monitoring is sufficiently precise for the diagnosis of sleep apnea are limited. RESEARCH QUESTION: The current study sought to determine the variability and misclassification in disease severity over three consecutive nights in a large sample of patients referred for sleep apnea.
methodsA sample of 10,340 adults referred for sleep apnea testing was assessed. A self-applied type III monitor was used for three consecutive nights. The apnea-hypopnea index (AHI) was determined for each night, and a reference AHI was computed by using data from all 3 nights. Pairwise correlations and the proportion misclassified regarding disease severity were computed for each of the three AHI values against the reference AHI.
resultsStrong correlations were observed between the AHI from each of the 3 nights (r = 0.87-0.89). However, substantial within-patient variability in the AHI and significant misclassification in sleep apnea severity were observed based on any 1 night of monitoring. Approximately 93% of the patients with a normal study on the first night and 87% of those with severe sleep apnea on the first night were correctly classified compared with the reference derived from all three nights. However, approximately 20% of the patients with mild and moderate sleep apnea on the first night were misdiagnosed either as not having sleep apnea or as having mild disease, respectively.
conclusionsIn patients with mild to moderate sleep apnea, one night of portable testing can lead to misclassification of disease severity given the substantial night-to-night variability in the AHI.
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Registered trials
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.