0458 Does Simulated Limited-Channel Home Sleep Study Testing Accurately Predict The Diagnosis Of Sleep-disordered Breathing In Patients With Spinal Cord Injury, Or Disease?. (12th April 2019) - Zeineddine, Salam
Abstract: Introduction: Sleep-disordered breathing (SDB) is highly prevalent among patients with spinal cord injury or disease (SCI/D). In-laboratory polysomnography (PSG) is difficult for these patients due to functional limitations and the physical construction of most sleep laboratories. Our objective was to assess whether simulated limited-channel home sleep studies could accurately diagnose SDB in Veterans patients with SCI/D. Methods: Within a larger study, 20 Veterans with SCI/D completed one night of in-laboratory PSG. Limited-channel home sleep studies were simulated by extracting in-laboratory PSG channels to include solely the following information: nasal pressure, thermistor, thoracic and abdominal belts, and oxygen saturation. The full PSGs and limited-channel recordings were put in random order and were staged and scored by a single sleep physician. Results: Mean age of patients was 59.50 ± 12.25 years; 85% were male, and the average BMI was 26.55 ± 4.82. The mean Apnea-Hypopnea Index (AHI) was 34.59 ± 25.23. Eighteen patients (90%) had SDB defined as AHI ≥5/hour. Simulated limited-channel home sleep studies accurately predicted SDB in 17 out of 18 patients (95%). Both negative PSG studies also yielded negative limited-channel home sleep studies. Conclusion: In patients with SCI/D, limited-channel home sleep studies may be a viable alternative to in-laboratory PSG. Home sleep apnea testing (HSAT) may increase access to diagnostic testing; However, our study did not address the limitations of conducting limited channel studies in the home environment under unmonitored conditions. Our findings support the diagnostic accuracy of limited-channel studies in SCI/D patients. Further research on the usability of HSAT devices in this patient population is needed. Support (If Any): VA Rehabilitation Research and Development Service (RX002116; PI Badr) and NIH/NHLBI (K24HL143055; PI: Martin)