A Systematic Review on the Technical Feasibility of Home-Polysomnography for Diagnosis of Sleep Disorders in Adults

Abstract

Purpose of Review: The increasing demand for sleep diagnostic studies represents a challenge for many healthcare systems. Home polysomnography (hPSG), either set up by a technician or self-applied by the patient, provides comprehensive sleep signals and has the potential to replace in-lab sleep studies in a large number of cases.The aim of this study is to assess the existing evidence regarding the technical feasibility of hPSG in a systematic review. A systematic literature search was conducted in MEDLINE, PubMed, and Google Scholar to identify relevant research. Using a priori-defined inclusion criteria, studies were reviewed by three researchers, and a quality assessment was conducted. Relevant data were extracted, and the pooled failure rate with hPSG was computed. Additional subgroup analyses were conducted to further assess factors influencing technical feasibility. Recent Findings: Thirty studies totaling 14,465 patients were included (mean sample size 482 ± 1289 participants). Common deployment models for hPSG were at-home application by a technician (58%) and technician-led in-hospital set-up (31%), followed by at-home self-application by the patient (11%). Technical failure rate across the studies ranged from 0 to 23.4%, with a pooled failure rate of 7.8% (95% CI 5.5–10.1%). Depending on deployment models, failure rates varied slightly. Failures of hPSG were largely related to signal acquisition. No studies reported adverse events from hPSG. Patient preferences were assessed by eleven studies, with 56% (range 22–95%) preferring hPSG over in-lab recording. Summary: Based on the research identified for this review, home PSG is safe and technically feasible with relatively low failure rates. Further research is required to better understand decision-making with this tool in comparison to other sleep diagnostic procedures.