0574 False Negative Rate of Single-Night Home Sleep Apnea Testing for CPAP Qualification: Evidence from Multi-Night Analysis

Abstract Introduction Single-night home sleep apnea testing (HSAT) is a clinical practice currently used to determine a patient’s CPAP eligibility (AHI>5). Although useful, there is variability in night-to-night results, which may lead to false-negative conclusions. Consequently, patients who would qualify on subsequent nights may be denied treatment. The extent of this issue has not been identified. Methods We examined 4,197 de-identified patients with multi-night HSAT data using 3% desaturation criteria. (Each patient had about 2-7 nights each, totaling 12,008 nights in total). Patients were tagged as night-1 negative if the initial study showed an sAHI < 5. We determined how many of these initially negative patients later demonstrated sAHI ≥ 5 on later nights, representing false negatives for CPAP qualification. Results 449 or 10.7% of the 4,197 patients analyzed had a negative initial study (night-1 sAHI < 5). Among these initially negative patients, 224 or 49.9% subsequently demonstrated sAHI ≥ 5 on one or multiple additional nights. This represents false negatives who would have been denied CPAP based solely on single-night testing. Conclusion Among the patients who completed a single-night HSAT, roughly 50% of those patients whose test results came back as negative actually had sleep apnea and qualified for CPAP. By utilizing multi-night testing protocols, it will ensure that patients receive proper treatment, have access to CPAP therapy, and ultimately reduce the rate of false negatives in sleep apnea. These findings are crucial for clinical practice procedures, insurance coverage policies, and guarantees that those with genuine sleep apnea aren’t overlooked. Support (if any)