Laboratory Polysomnography or Limited-Channel Sleep Studies for Obstructive Sleep Apnea
Authors: Cathy Goldstein
Journal: Annals of Internal Medicine (2017)

Letters3 October 2017Laboratory Polysomnography or Limited-Channel Sleep Studies for Obstructive Sleep ApneaCathy Goldstein, MD, MSCathy Goldstein, MD, MSFrom University of Michigan, Ann Arbor, Michigan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0282 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Chai-Coetzer and colleagues (1) conclude that level 3 testing for obstructive sleep apnea (OSA) is not inferior to level 1 testing. I congratulate the investigators on their rigorous, multicenter, noninferiority study with both intention-to-treat and perprotocol analyses but would like to highlight the critical limitation that received minimal attention. Given that this article was published in a journal whose readership includes perhaps the most valuable stakeholder in the treatment of OSA—the primary care physician who does not specialize in sleep medicine—the importance of this limitation deserves greater focus.Home sleep apnea testing (HST) is well-accepted by the ...References1. Chai-Coetzer CL, Antic NA, Hamilton GS, McArdle N, Wong K, Yee BJ, et al. Physician decision making and clinical outcomes with laboratory polysomnography or limited-channel sleep studies for obstructive sleep apnea. A randomized trial. Ann Intern Med. 2017;166:332-40. [PMID: 28114683]. doi:10.7326/M16-1301 LinkGoogle Scholar2. Collop NA, Anderson WM, Boehlecke B, Claman D, Goldberg R, Gottlieb DJ, et al; Portable Monitoring Task Force of the American Academy of Sleep Medicine. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2007;3:737-47. [PMID: 18198809] CrossrefMedlineGoogle Scholar3. Epstein LJ, Kristo D, Strollo PJ, Friedman N, Malhotra A, Patil SP, et al; Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5:263-76. [PMID: 19960649] CrossrefMedlineGoogle Scholar4. El Shayeb M, Topfer LA, Stafinski T, Pawluk L, Menon D. Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis. CMAJ. 2014;186:E25-51. [PMID: 24218531] doi:10.1503/cmaj.130952 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Michigan, Ann Arbor, Michigan.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0282. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPhysician Decision Making and Clinical Outcomes With Laboratory Polysomnography or Limited-Channel Sleep Studies for Obstructive Sleep Apnea Ching Li Chai-Coetzer , Nick A. Antic , Garun S. Hamilton , Nigel McArdle , Keith Wong , Brendon J. Yee , Aeneas Yeo , Rajeev Ratnavadivel , Matthew T. Naughton , Teanau Roebuck , Richard Woodman , and R. Doug McEvoy Laboratory Polysomnography or Limited-Channel Sleep Studies for Obstructive Sleep Apnea Ching Li Chai-Coetzer , Nigel McArdle , and R. Doug McEvoy Metrics 3 October 2017Volume 167, Issue 7Page: 521KeywordsContinuous positive airway pressureHeart rateIntent to treat analysisObstructive sleep apneaPolysomnographyPrimary care physiciansPulse oximetryResearch laboratoriesSleepSleep apnea ePublished: 3 October 2017 Issue Published: 3 October 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...