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The accuracy of a portable sleep monitor to diagnose obstructive sleep apnea in adolescent patients.

STUDY OBJECTIVES
The efficacy of portable monitor (PM) sleep testing in children is not well understood. While most studies have evaluated PM in a lab setting, the utility of PM in the home environment is relatively unknown. We sought to determine whether home PM accurately diagnoses obstructive sleep apnea (OSA) in adolescents and to assess patient satisfaction with home PM sleep testing.


METHODS
We evaluated adolescents (age 12-18 years) with suspected OSA using a PM device. In addition to in-laboratory PSG, all subjects had PM testing performed twice, once in their home and once concurrent to in-laboratory PSG. PM was compared to PSG using two primary outcomes: the apnea hypopnea index (AHI) and oxygen desaturation index (ODI). All subjects were approached for interview to evaluate their experience with PM sleep testing.


RESULTS
Twenty adolescents participated. Bland-Altman analysis comparing the AHI and ODI determined by home or in-laboratory PM to in-laboratory PSG, revealed mostly agreement; however, some deviations were observed when either parameter was markedly increased. While PM testing tended to underestimate the AHI, the diagnostic agreement between home PM and PSG was 80% (by the White-Westbrook method). Most preferred PM to PSG and found PM easy to very easy to set up.


CONCLUSIONS
In a small cohort of adolescents, our study supports the application of home PM in the diagnosis of suspected OSA. Until studies implementing PM using larger cohorts become readily available, the findings from this preliminary study could help with adolescents receiving sleep apnea therapy more promptly.


CLINICAL TRIAL REGISTRATION
Registry: ClinicalTrials.gov; Identifier: NCT03748771.