Clinical diagnosis of XXXX based on single night of polysomnography vs. two nights of polysomnography.

@entity1 @entity15203 @entity387 @entity25 @entity386
PURPOSE: The purpose of this study was to investigate @entity386 - @entity387 index (AHI) across two polysomnographies (PSGs) to examine AHI variability and impact on clinical diagnosis. MATERIALS AND METHODS: Two-night PSGs of 193 @entity25 @entity1 were reviewed, and the AHI variability was analyzed. Anonymized records from five @entity1 with significant night-to-night AHI variability were used in this study: the two-night PSGs from two @entity1 were represented as four individual PSGs; the two-night @entity15203 for two others were represented as being obtained from two different sleep clinics; the last @entity1 's @entity15203 was shown as a two-night study. Twenty-two sleep experts attending the Associated Professional Sleep Societies meeting were recruited to make diagnoses based on the PSGs. They were told that the PSGs were from seven @entity1 : four with single-night @entity15203 ; two with two PSGs, each one from a different clinic; and one @entity1 with a two-night @entity15203 . RESULTS: Twenty-one percent of the 193 @entity25 @entity1 had a nightly @entity15203 AHI variability of greater than 5. Forty-eight percent of all @entity1 had a significantly higher AHI on the first night, and 41% had a significantly higher AHI on the second night. Using an AHI > 15 diagnostic criteria, @entity387 would have been undetected in 20% (n = 39) of @entity1 due to low AHI on one night. Furthermore, 13% of all @entity1 had a more severe @entity387 classification based on the second night of @entity15203 . For the seven cases, 27-36% of sleep experts failed to identify @entity387 especially when presented with the @entity15203 containing the lower AHI. Incidences of missed @entity387 diagnoses were reduced to 15-18% when information from two PSGs was presented to the sleep experts. CONCLUSIONS: Utilizing a large @entity1 population, this study supports the significant night-to-night variability in @entity15203 respiratory variables. @entity387 in some @entity1 is reduced when sleep experts are provided with only one @entity15203 recording. The clinical implication is that about 13% of @entity25 @entity1 might benefit from a second night of @entity15203 .
