SPLIT-NIGHT STUDIES FOR THE DIAGNOSIS AND TREATMENT OF SLEEP-DISORDERED BREATHING

We examined the effect of split-night polysomnography on compliance wi th positive pressure via a mask for the treatment of obstructive sleep -disordered breathing. A comparison of objective compliance (hours/day ) at the first meter read from the positive-pressure device (4-6 weeks after set-up) in patients who had a successful split-night positive-p ressure titration vs. patients who had traditional full-night positive -pressure titration was performed. Patients were matched for age, sex, and severity of the obstructive sleep-disordered breathing. Twelve pa tients were matched with controls who underwent full-night polysomnogr aphy. There were no significant differences between the split-night pa tients and the full-night patients with regard to age, sex, body mass index, and pretreatment Epworth Sleepiness Score. In addition, there w as no significant difference between apnea-hypopnea index and the desa turation-event frequency for both groups pre- and post-treatment. The average daily use of continuous positive airway pressure (CPAP) at the time of the first meter reading in the group that underwent full-nigh t positive-pressure titrations as opposed to split-night titrations wa s 5.2 hours/day +/- 2.2 vs. 3.8 hours/day +/- 2.9, respectively (p = 0 .29). The Epworth Sleepiness Scale on the initial clinic visit (as an index of patient-perceived impairment) did not predict compliance at 4 -6 weeks. The time at the final positive pressure did not correlate wi th compliance. Acceptance of positive pressure in the split-night pati ents ranged from 62 to 67%.