Home sleep testing (HST)

Abstract

Obstructive sleep apnea(OSA) is the commonest variety of sleep apnea syndromes having a significant prevalence amongst the Indian population. But despite being a common disease, a large number of cases remain undiagnosed due to lack of diagnostic facilities. Though full polysomnography(PSG) is considered as the “gold standard” for the diagnosis of OSA, it is expensive, labour-intensive and has limited availability. Hence, the need for a strategy like Home sleep testing(HST), which is substantially less expensive and more readily available, thereby helping the physician in achieving a higher rate of diagnosis and treatment of OSA. HST may be used for diagnosis of OSA in patients with a high pretest probability of moderate to severe OSA, when PSG is not possible by virtue of immobility, safety or critical illness and for monitoring of non-continuous positive airway pressure(CPAP) based therapy. Various studies have shown that HST have a high degree of accuracy and is comparable to inlaboratory PSG with respect to improvement in sleep apnea-specific quality of life(SAQLI) and compliance to CPAP therapy. Though HST may not be as accurate as PSG, the modest reduction in its accuracy is counterbalanced by its timeliness, the greater patient access afforded and the substantially lower cost.