The use of portable monitoring for sleep apnea diagnosis in adults

Abstract

Due to increasing demand for sleep services, there has been growing interest in ambulatory models of care for patients with obstructive sleep apnea (OSA). The implementation of alternative approaches to the current management by full polysomnography (PSG) in the sleep laboratory is necessary for diagnosing this syndrome due to the high cost of full-night PSG. A good alternative option for OSA diagnosis is portable monitoring (PM), which is known for its accuracy, ease of management and lower cost when compared with full PSG. PM has not been well validated for OSA diagnosis in patients with medical comorbidities or in elderly individuals and children. PM may be recommended as an alternative method to PSG for patients with high clinical risk for OSA. In the present review, we describe the use of PM for OSA diagnosis and evaluate the current progress, costs, limitations and applications of these devices in various groups of patients, particularly for patients with comorbid diseases.

Keywords::

• home unattended portable monitoring
• obstructive sleep apnea
• out-of-center sleep testing
• polysomnography
• polygraphy
• portable monitoring

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• An epidemiological study conducted in the city of São Paulo found obstructive sleep apnea (OSA) in 32.8% of the adult population, and the current prevalence estimated in Wisconsin for moderate to severe OSA is 10%.

• The use of portable monitoring is becoming increasingly acceptable for OSA diagnosis in patients with a high probability of exhibiting OSA based on a pretest and after a careful clinical assessment.

• There are a few studies investigating Portable Monitoring for OSA diagnosis in patients with comorbidities that have shown limitations to its use.