Ambulatory Versus Laboratory Polysomnography in Obstructive Sleep Apnea: Comparative Assessment of Quality, Clinical Efficacy, Treatment Compliance, and Quality of Life

Study Objectives: This study has as its primary objective to evaluate the quality and effectiveness of type II ambulatory polysomnography (Amb-PSG) versus type I attended laboratory polysomnography (Lab-PSG) in diagnosing obstructive sleep apnea (OSA). Its secondary objective is to evaluate the clinical efficacy, quality of life (QoL), and treatment adherence after diagnosis. Methods: An observational study of patients with OSA (n = 225) in whom diagnosis was made via Amb-PSG (n = 114) or Lab-PSG (n = 111). Patients' clinical data were retrospectively assessed (including general demographic and clinical data, Epworth Sleepiness Scale, blood pressure, indices from polysomnography, and treatment adherence. Cross-sectional assessment (patient questionnaire) was used to evaluate clinical efficacy indicators, comorbidities, current treatment, and QoL. Results: Polysomnography indices were comparable between Amb-PSG and Lab-PSG (apnea-hypopnea index: 38.9 +/- 22.5 versus 35.8 +/- 23.1 events/h; P > .05), except for an elevation of total sleep time (510 +/- 54.7 versus 476.3 +/- 79.4 minutes; P < .01) and loss of oximetry signal (9.8%versus 0.0%; P < .05). Based on polysomnography parameters, OSA was severe in 119 patients (52.9%), moderate in 88 (39.1%), and mild in 18 (8.0%). Diagnostic effect of Amb-PSG in clinical (body mass index, blood pressure, Epworth Sleepiness Scale) and treatment follow-up (CPAP adherence and QoL) indicators was comparable to that of Lab-PSG. Conclusions: Amb-PSG showed an OSA diagnostic capacity comparable to Lab-PSG. Secondary analyses (diagnostic quality, clinical efficacy, treatment compliance, QoL) underline the value of Amb-PSG as an emerging alternative to improve accessibility to care.