New guidelines from the American Academy of Sleep Medicine (AASM) state that a home sleep test can help detect obstructive sleep apnea (OSA) in select adults.

In developing the guidelines, a task force was appointed to answer 4 questions:

1. What are appropriate indications for portable monitoring?
2. What types of portable monitoring should be used?
3. How should portable monitoring data acquisition, analysis, and interpretation be performed?
4. What is the proper application of portable monitoring results?

According to an abstract of the guidelines, the task force recommended the following recommendations for portable monitoring usage:

• Unattended portable monitoring (PM) for the diagnosis of OSA should be performed only in conjunction with a comprehensive sleep evaluation.
• Clinical sleep evaluations using PM must be supervised by a practitioner with board certification in sleep medicine or an individual who fulfills the eligibility criteria for the sleep medicine certification examination.
• PM may be used as an alternative to polysomnography (PSG) for the diagnosis of OSA in patients with a high pretest probability of moderate to severe OSA.
• PM is not appropriate for the diagnosis of OSA in patients with significant comorbid medical conditions that may degrade the accuracy of PM.
• PM is not appropriate for the diagnostic evaluation of patients suspected of having comorbid sleep disorders.
• PM is not appropriate for general screening of asymptomatic populations.
• PM may be indicated for the diagnosis of OSA in patients for whom in-laboratory PSG is not possible by virtue of immobility, safety, or critical illness.
• PM may also be indicated to monitor the response to non-CPAP treatments for sleep apnea.

The “Clinical Guidelines for the Use of Unattended Portable Monitors in the Diagnosis of Obstructive Sleep Apnea in Adult Patients” can be viewed in its entirety in the December 15 issue of the Journal of Clinical Sleep Medicine.