Home Care NetWork
Home Care Literature Reviews 2003
Obstructive Sleep Apnea:
Li CK, Flemons WW. State of home sleep studies. Clin Chest Med. 2003;24:283-95
This Canadian review evaluates the utility of different portable sleep monitors. Home monitors without oximetry are sensitive but not specific and the addition of oximetry improves specificity. Limited evidence is available for many portable monitors in the unattended setting, and further research is required in this area, but this review offers useful rules of thumb for clinicians.
Doherty LS, Kiely JL, Lawless G, McNicholas WT. Impact of nasal continuous positive airway pressure therapy on the quality of life of bed partners of patients with obstructive sleep apnea syndrome. Chest. 2003;124:2209-14.
This Irish survey of 55 bed partners of patients with obstructive sleep apnea being treated with continuous positive airway pressure (CPAP) found that the bed partners reported significant improvements in sleep, anxiety, role limitation due to physical problems, role limitation due to emotional problems, social functioning, mental health, and energy/vitality (all p < 0.05). CPAP benefits the whole family.
Kirk VG, Bohn SG, Flemons WW, Remmers JE. Comparison of home oximetry monitoring with laboratory polysomnography in children. Chest. 2003;124:1702-8.
This Canadian prospective cohort study compared the accuracy and reliability of a portable home oximetry monitor with a laboratory-based automated sleep analysis for the diagnosis of obstructive sleep apnea in children presenting to a sleep clinic. While the test-retest reliability of the portable monitor-based desaturation index between 2 nights at home and between laboratory and home were high, the sensitivity and specificity of the home monitor for recognizing moderate sleep apnea (i.e., polysomnography Apnea Hypoxia Index > 5/h) were only 67% and 60%, respectively. Home oximetry was not comparable to laboratory-based automated sleep analysis in these children.
Poels PJ, Schilder AG, van den Berg S, Hoes AW, Joosten KF. Evaluation of a new device for home cardiorespiratory recording in children. Arch Otolaryngol Head Neck Surg. 2003;129:1281-4.
This Dutch case series of 53 eligible children scheduled for adenotonsillectomy to treat habitual snoring and/or apneas at otorhinolaryngology clinics evaluated a single-night unattended home cardiorespiratory recording device. Technically acceptable recordings were obtained in only 18 of the 24 children who completed the testing and only 7 recordings were classified as accurate. Another disappointing result from home monitoring in children.
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