Comparison between home and hospital set-up for unattended home-based polysomnography: A prospective randomised study

Background: Unattended home-based polysomnography (H-PSG) is a reliable tool for the diagnosis of obstructive sleep apnea (OSA). The quality of the recording can be influenced by several factors including the set-up location- at home versus in the sleep lab. Previous studies have suggested that the failure rate is higher when H-PSG is fitted in hospital. The purpose of this study was to determine the influence of hook-up location on H-PSG recording quality. Methods: Consecutive patients suspected of OSA were selected. Each patient underwent two H-PSG within two weeks, one fitted at home and one fitted in the sleep-lab. The order of H-PSG was randomly assigned. Results: 102 patients were included, and the OSA diagnostic was positive for 59%. 93% of the 190 H-PSG were satisfactory. Failure rate of H-PSG was similar for both the home set-up and the sleep lab set-up (p=0.33). Reproducibility of the apnea-hypopnea index was good on both nights (intraclass correlation coefficient of 0.85). We did not observe the first-night effect during the first H-PSG. 67% of patients opted to be fitted at home. Conclusion: The present study offers the opportunity to simplify home-unattended polysomnographic recordings, by demonstrating that hospital hook-up is as efficient as home hook-up in obtaining good quality recordings.