EVALUATION OF A COMPUTERIZED POLYSOMNOGRAPHIC SYSTEM

Computerized polysomnographic systems have came into common use in sle ep laboratories around the world. Despite potential advantages over st andard paper polysomnograpy, these computerized systems have been mini mally evaluated as to accuracy, analysis time, or cost effectiveness w hen compared to paper. We evaluated the Healthdyne ALICE (R) 3 system for comparability to paper polysomnography in sleep quantification and technician analysis time. Fifty patients were recorded simultaneously both on paper and on the ALICE (R) 3 system and analyzed blindly with summary data from these records being quantified and compared. Five a dditional patients were studied for epoch-by-epoch analysis. Score-res core assessments were accomplished for both groups. The results indica te that when allowed to autoscore, this computerized system produced s ubstantial errors in sleep staging (REM sleep time 56.4+4.9 minutes vs 73.2+8.4 minutes for paper versus computer). This was the case for re spiratory (AHI of 26.5+ 4.3 vs 15.3+2.6 for paper vs computer) and aro usal assessment as well. However, with editing, similar results to tho se obtained with paper were achieved (REM sleep time - 56.4+4.9 vs 59. 0+4.6; AHI - 26.5+4.3 vs 26.1+4.7 for paper and computer respectively) , with differences rarely exceeding score-rescore discrepancies. Analy sis time was substantially reduced by use of the computer (172.6+9.9 v s 79.7+4.8 minutes for paper vs computer). Epoch-by-epoch analysis rev ealed a trend to score toward wakefulness or lighter sleep on computer compared to paper although the differences were small. Respiratory, a rousal and PLM scoring were quite similar. In conclusion, this study s uggests that the ALICE (R) 3 system with editing can produce results s imilar to those obtained with paper.