Predicting Technical Success in Home Sleep Apnea Test

Background: Home sleep apnea tests are economical but their technical failure rate is higher than with in-lab studies. We aimed to predict factors related to failures. Methods: Altogether, 1,055 consecutive respiratory polygraphy recordings for subjects aged 16-90 years (38% female) were included. The sleep nurses were asked to predict the success of the upcoming recording according to their experienced perception. The recording was considered successful if the main recorded parameters (nasal flow, thoracic and abdominal movements, blood oxygen saturation, snoring, and posture) were intelligible during ≥80% of the night. Results: Defects due to a recording device caused a failure rate of 4.4%, and those recordings were excluded from further analyses. Subject-related reasons caused a failure rate of 10.4% (i.e. 70% of all failures). There were no statistically significant differences in the failure rate regarding gender, age, education level, ESS, smoking habits, BMI, comorbidities, sharing a bed with someone, having small children or pets, being outside of working life, or working irregular hours. Nurse’s prediction of reliability sorted out successful and unsuccessful recordings statistically significantly (P=0.035). The technical success was not statistically significantly different between first-time and repeated recordings. Conclusions: Background characteristics of the subject or conditions during the recording did not predict the failure of home sleep apnea test. An experienced nurse could still predict the technical success of the recording based on her perception. Even if the first test failed, it is still worthwhile to retest at home, as the failure rate in repeated recordings stayed low.