Documentation of polysomnographic and home sleep apnea test interpretations: room for improvement?

To our knowledge, this study is the first to evaluate documentation of sleep study quality criteria or OSA phenotypes in the interpretations and clinical notes. The demographic characteristics of our patient cohort were similar to those of other studies regarding sleep apnea with most patients being male, obese, and aged 50 to 59 years. The median AHI was 8.75 events/h, and 37% of patients had an AHI of 15 or more events/h. Our study showed that the proportion of patients with severe OSA did not differ among study types and that sleep apnea phenotypes (POSA or OSA without obesity) were commonly undocumented.

POSA was observed in 15% of patients using sleep study parameters but was not documented most of the time. POSA, at least with our predetermined criteria, was identified more frequently on HSAT than PSG. This may reflect the influence of technologists urging patients into specific sleep positions, the duration of testing during a split-night PSG vs a whole night of sleeping at home, or the effect of encumbrance by the many leads and sensors required for PSG vs HSAT testing. To our knowledge, this has not been previously noted. It is important to recognize POSA because it may respond to oral appliances and specific positional therapies.

https://jcsm.aasm.org/doi/full/10.5664/jcsm.10460