Day-time split study for management of obstructive sleep apnoea: Proof of concept study

Objective: Waiting time for diagnosis and treatment of obstructive sleep apnoea (OSA) is increasing due to a lack of adequate amount of sleep labs. This study was done to find out the feasibility of daytime split Polysomnography (PSG) in patients with excessive daytime sleepiness (EDS) so as to reduce waiting time in sleep labs. Methods: Thirty patients with EDS (defined by Epworth Sleepiness scale ≥14) underwent both dPSG (daytime) and nPSG (nighttime). Diagnostic sleep parameters, titration pressures were compared. A questionnaire consisting of 12 questions for the experience of patients, technicians, and physicians was filled out after each dPSG and nPSG. Results: Thirty patients (11 females and 19 males) underwent both dPSG and NPSG. The mean age and BMI were 55.23 ± 8.1 years and 36.11 ± 7.70 kg/m², respectively. PSG parameters (sleep efficiency, total sleep time, time in bed) were not different in the two groups. During dPSG titration, optimal, good and adequate titration was achieved in 22%, 19% and 52% respectively, compared to 33%, 15% and 44% during nPSG. In the Likert scale questionnaire, patients had comparable sleep quality in both PSGs. Technicians felt more sleepy during nPSG, and most technicians preferred dPSG over nPSG. Physicians’ agreement with titration done by technicians was equal in both dPSG and nPSG. Conclusions: Daytime split PSG may be a viable alternative to night PSG in patients with OSA with excessive sleepiness. This can ensure early treatment of patients with OSA.