Reliability of Home Respiratory Polygraphy for the Diagnosis of Sleep Apnea-Hypopnea Syndrome. Analysis of Costs

• Published in: Archivos de bronconeumología (English ed.) 2008, Vol.44 (1), p.22-28
• Main Authors: de la Luz Alonso Álvarez, María, Santos, Joaquín Terán, Guevara, José Cordero, Martínez, Mónica González, Pascual, Luis Rodríguez, Bañuelos, José Luis Viejo, Cabello, Ángel Marañón
• Format: Article
• Language: eng ; spa
• Subjects: Adolescent; Adult; Aged; Costs and Cost Analysis; Diagnostic Techniques, Respiratory System; Estudios de sueño domiciliarios; Female; Home sleep study; Humans; Male; Middle Aged; Poligrafía respiratoria; Polisomnografía; Polysomnography; Prospective Studies; Reproducibility of Results; Respiratory polygraphy; Sleep Apnea Syndromes - diagnosis; Sleep Apnea Syndromes - economics; Sleep apnea-hypopnea syndrome; Síndrome de apneas-hipopneas durante el sueño
• ISSN: 1579-2129; 0300-2896; 1579-2129
• DOI: 10.1016/S1579-2129(08)60005-1

To evaluate the reliability of home respiratory polygraphy for the diagnosis of sleep apnea-hypopnea syndrome (SAHS) and to compare the cost of this technique with that of nighttime polysomnography performed in a sleep laboratory. This was a prospective study of a random sample of patients with clinically suspected SAHS in which the participants who underwent both home respiratory polygraphy and nighttime polysomnography were blinded as to the results of their first test. Costs were calculated based on a theoretical population of 1000 individuals. A t test for paired samples, the Pearson correlation coefficient, and a receiver operator characteristic curve were used for the statistical analysis. The study population was composed of 45 patients with a mean (SD) age of 52.3 (11) years of whom 21 (46.6%) were diagnosed with SAHS, defined by an apneahypopnea index greater than 10 in nighttime polysomnography. Comparison of the results obtained in both recordings revealed statistically significant correlations for all comparisons. The optimal cutoff in this population was a respiratory disturbance index of 13.7 or more, for which the area under the receiver operating characteristic curve was 87.5% (95% confidence interval, 74.2%-95.4%). The mean cost of home respiratory polygraphy in a patient with suspected SAHS was € 69, whereas that of polysomnography was € 179. Home respiratory polygraphy is a reliable technique for the diagnosis of SAHS. Using this technique routinely in patients suspected of SAHS will be more economical than using nighttime polysomnography. Uncertain results must be verified by nighttime polysomnography. El presente estudio se realizó con siguientes objetivos: a) valorar la fiabilidad de la poligrafía respiratoria domiciliara (PRD) para el diagnóstico de síndrome de apneashipopneas durante el sueño (SAHS), y b) comparar los costes derivados de la realización de PRD con los de la polisomnografía nocturna (PSG) efectuada en el laboratorio de sueño. Se trata de un estudio prospectivo y ciego. La población de estudio estuvo constituida por una selección aleatoria de pacientes con sospecha clínica de SAHS. A todo paciente incluido en el estudio se le realizaron PRD y PSG sin conocer el resultado de primera. Para el cálculo de costes se utilizó una población teórica de 1.000 personas. Para el análisis estadístico se emplearon la prueba de la t de Student para muestras emparejadas, el coeficiente de correlación de Pearson y el cálculo de las cur