Different types of diagnostic sleep testing
| Sleep test | Indications for use | Operating characteristics for sleep testing modality* (20) | |
|---|---|---|---|
| AHI ≥ 5 events/h | AHI ≥ 15 events/h | ||
| Polysomnography | |||
| Attended (level I study) | Low-to-moderate probability of OSA Nondiagnostic HSAT/oximetry and suspected OSA Suspected sleep disorder other than OSA Suspected CSA or hypoventilation | Gold standard | Gold standard |
| Unattended (level II study) | Predominantly used for research purposes | Sn: 0.88–0.97 Sp: 0.50–0.56 | Sn: 0.94–0.95 Sp: 0.76–0.77 |
| Home sleep apnea testing | |||
| Level III study | Moderate-to-high probability of OSA without comorbidity Unable to perform PSG because of immobility or infirmity Confirm treatment efficacy | Sn: 0.90–1.00 Sp: 0.30–0.67 | Sn: 0.66–0.88 Sp: 0.62–1.00 |
| Two- or three-channel study | Sn: 0.80–0.96 Sp: 0.65–0.83 | Sn: 0.66–0.88 Sp: 0.62–1.00 | |
| Single-channel study | Sn: 0.96† Sp: 0.82† | Sn: 0.55–0.91 Sp: 0.70–0.82 | |
| Peripheral arterial tone study | Sn: 0.96† Sp: 0.43† | Sn: 0.92–0.96 Sp: 0.77–1.00 | |
Note: AHI = apnea–hypopnea index, CSA = central sleep apnea, HSAT = home sleep apnea testing, OSA = obstructive sleep apnea, PSG = polysomnography, Sn = sensitivity, Sp = specificity.
↵* Operating characteristics of these testing modalities when compared with PSG and reported for high-prevalence populations (estimated prevalence 87%). (37)
↵† Based on one validation study.