Portable Monitoring for Diagnosis of Sleep Apnea

Economic and access issues are driving the use of portable monitoring for primary diagnosis of obstructive sleep apnea (OSA) in selected adults. Its applicability has been demonstrated for adults at high risk of sleep apnea, but many caveats and research questions remain. For technical reasons, most limited-channel diagnostic devices tend to underestimate the severity of the disease. In addition, portable monitoring is of little value for sleep disorders other than OSA and has not been advocated for children or the elderly. Similarly, auto-continuous positive airway pressure (APAP) is an alternative to in-laboratory continuous PAP titration. The cost-effectiveness of portable diagnostic testing and APAP titration in actual practice is yet to be determined, but will be a critical question in the years ahead. Future research should examine their use for extended populations, and the economic effect of these modalities, to determine the best use of these techniques as alternatives to traditional in-laboratory testing. © 2013, Springer Science+Business Media New York.