Sleep monitoring devices

	Type 1 device (Attended polysomnography)	Type 2 device (Unattended polysomnography)	Type 3 device (Portable HSAT)		Type 4 device (Single or dual bioparameter recording)
				Example of a type 3 device*
Minimal measurements	EEG EOG Chin EMG ECG Airflow Respiratory effort Oxygen saturation	EEG EOG Chin EMG ECG Airflow Respiratory effort Oxygen saturation	Minimum 4 parameters, typically: Two ventilation parameters (eg, respiratory movement or airflow) Heart rate or ECG Oxygen saturation (No EEG)	PAT, oximetry, heart rate, snoring actigraphy, body position	Only 1 or 2 variables measured (typically oxygen saturation, airflow, chest movement)
Body position	Measured or observed	Possible but optional	Possible	Yes	No
Sleep staging	Yes	Yes	No	No	No
Sleep surrogate	Not applicable	Not applicable	Possible	Yes (PAT actigraphy)	No
Leg movement	Documented by EMG or motion sensor	Possible but optional	Possible but optional	No	No
Personnel	Present	Absent	Absent	Absent	Absent
Interventions possible	Yes	No	No	No	No
Respiratory event terminology (denominator)	AHI (total sleep time)	AHI (total sleep time)	REI (total recording time)	pAHI, pRDI (PAT algorithm)	REI (total recording time)

Some Medicare administrative contractors only recognize AHI for PAP coverage. Clarification with local coverage determinator contractors may be required.

HSAT: home sleep apnea testing; EEG: electroencephalography; EOG: electrooculography; EMG: electromyography; ECG: electrocardiography; PAT: peripheral arterial tonometry; AHI: apnea hypopnea index; REI: respiratory event index; pAHI: PAT-determined apnea hypopnea index; pRDI: PAT-determined respiratory event index; PAP: positive airway pressure; AASM: American Academy of Sleep Medicine; CMS: Centers for Medicare and Medicaid Services.
* The classification of devices that include PAT is challenging. While many experts consider them as type 3 devices (per the original AASM classification), the CMS classify them as a type 4 device.

References:

Ferber R, Millman R, Coppola M, et al. Portable recording in the assessment of obstructive sleep apnea. ASDA standards of practice. Sleep 1994; 17:378.
Littner MR. Portable monitoring in the diagnosis of the obstructive sleep apnea syndrome. Semin Respir Crit Care Med 2005; 26:56.

Graphic 121906 Version 1.0

خرید پکیج

Sleep monitoring devices