Diagnosis of neurological and respiratory sleep disorders using home-video-PSG: preliminary results in 325 patients

<bold>Introduction</bold>: Polysomnography (PSG) is the International gold standard for the diagnosis of all sleep disorders. The home cardio-respiratory monitoring (CRM) is scientifically validated for in the suspicion of Sleep-disordered Breathing (SDB). The objective of the study is to evaluate the feasibility of the unattended Home-Video-PSG monitoring for all sleep disorders <bold>Methods:</bold> all the adult collaborating outpatients with a Sleep Disorder afferent to the Sleep Lab of the “Clinical Course” Neurophysiology Unit of Palermo between the years 2018-2019 were consecutively enrolled. Placement of all electrodes and sensors always took place in the lab and the recording was carried out at the patients' home without supervision <bold>Results:</bold> we recruited 325 patients (201 males, mean age 54.6, range 13-88). The final diagnoses were isolated sleep-disordered breathing (SDB) (35.1%), isolated neurological sleep disorders (14.8%), combined neurological-SDB (47.7%) and negative (2.5%). The video recording was confirmatory in 69.4% of cases, integrative or diagnostic in 18.2% and negative in 12.4%. Unsuccessful recordings were 7.3%; 4.6% cardio-respiratory pitfalls; 8.6% neurological artifacts <bold>Conclusions:</bold> home-video-PSG offers the opportunity for the evaluation of comorbid respiratory and neurological disorders. PSG allows to diagnose 14.8% of cases with neurological disorders that would be negative on CRM; it could help to improve ventilatory compliance in 47.7% of our patients with SDB and associated neurological disorders. Consequently, all patients with normal CRM or with poor ventilatory compliance should undergo complete polysomnography with nocturnal Video-EEG