Medical technology assessment of polysomnography, type 2: full psg at home. detection of naps and their clinical correlates

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Background: Polysomnography (PSG) in a clinical setting (PSG, type 1) is time consuming and expensive. Type 2, i.e. full PSG at home, is thought to be a good alternative, but has never been evaluated in terms of regular Medical Technology Assessment (MTA). In some countries this lack of MTA precludes reimbursement for PSG type 2. This communication is part of a series of posters which adds up to MTA of PSG type 2, and deals with the detection of daytime naps during two consecutive PSG’s at home. If succesfull, such PSG recordings might be an alternative for MSLT. Retrospective study of 442 patients (59% male, mean age = 44.8, SD= 16.7) who underwent full PSG type 2 for two consecutive days. We focus on the daytime naps found on the continuous recording and the recognition of these naps by the patients themselves, as shown in their diaries. Furthermore the results of the two PSG’s, type 2 were compared to continuous actigraphy over a period of 7 days. In our poster we try to give answers to the following questions: 1. Do patients have daytime naps? 2. Do patients who have daytime naps always recognize them? 3. Do the daytime naps contain REM and/or SWS? 4. Are the naps habitual or not? The results indicate that 58% of the patients have daytime naps during 2 consecutive 24-hour PSG’s (type 2). Those daytime naps are in 27% of the cases not recognized by the patients. We discovered that during the daytime naps 50% contains REM and/or SWS. Fifty-five percent of the naps found in the PSG’s (type 2) were habitual when assessed over 1 week actigraphy. Twenty-four-hour PSG’s type 2 gives good insight in the amount and quality of the sleep during daytime. One quarter of all naps was not recognized by the patients themselves. In comparison with the more global assessment through actigraphy, the PSG had a larger sensitivity.