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Volume 14 No. 07
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Scientific Investigations

Accuracy of Patient Perception of Supine Sleep

Peter D. Wallbridge, MBBS1,2; Thomas J. Churchward, RPSGT1,2; Christopher J. Worsnop, MBBS, PhD1,2
1Department of Respiratory and Sleep Medicine, Austin Hospital, Heidelberg, Australia; 2Institute for Breathing and Sleep, Heidelberg, Australia

Study Objectives:

For clinicians involved in investigating and treating sleep disorders, understanding the accuracy of patient recall of supine sleep would allow informed comparisons between polysomnography (PSG) and patient-reported sleep in patients with supine-predominant obstructive sleep apnea. This study aims to assess the accuracy of patient perception of supine sleep.

Methods:

Prospective observational cohort study, assessing patient perception of total sleep and supine sleep, including duration. Data were analyzed utilizing descriptive statistics, bias-plot (Bland-Altman) analysis, and Spearman correlation (rs) to analyze relationships among continuous data.

Results:

Total number of patients who underwent PSG was 518, with data from 368 of these patients analyzed. Most of these patients underwent diagnostic PSG (49.2%). Patients were excluded because of missing or incomplete data (n = 133) or immobility (n = 17). Some patients (n = 97, 26%) did not perceive supine sleep, with 34 (35% of those with unperceived supine sleep or 9% of whole group) of these having more than 60 minutes of PSG supine sleep (range 0–305.5 minutes). All “unsure” patients (n = 8, 2.2%) had significant supine sleep recorded (31.5–257.5 minutes). For the presence of any PSG supine sleep, questioning had a sensitivity of 77.9%, specificity 72.7% with positive predictive value of 96.7% and negative predictive value of 24.5%. There was a significant correlation (rs = 0.63, P < .0001) between perceived and PSG supine sleep, but wide limits of agreement (−246.9 to 194.2 minutes).

Conclusions:

In patients undergoing in-laboratory PSG, the perception of supine sleep predicts the presence of PSG supine sleep. However, questioning patients has a poor negative predictive value and patient estimates of supine sleep duration are inaccurate.

Citation:

Wallbridge PD, Churchward TJ, Worsnop CJ. Accuracy of patient perception of supine sleep. J Clin Sleep Med. 2018;14(7):1205–1208.




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