by Will Boggs, MD

Last Updated: 2008-04-25 14:08:41 -0400 (Reuters Health)

Conducting a sleep study in a hotel setting does not overcome the first-night effect that occurs in hospital-based sleep laboratories, according to a report in the April 15th issue of the Journal of Clinical Sleep Medicine.

The "first-night" effect refers to the alterations in sleep architecture, typically seen on polysomnography recordings the first night, which are thought to be associated with the unfamiliar environment and the technical equipment. Because of this, the data from the first night has usually been discarded. However, current cost restrictions and space limitations have confined sleep evaluations to one night.

"In this patient population," similar alterations in sleep architecture were seen on the first-night data recording at the hospital- or hotel-based laboratory, Dr. Kimberly N. Hutchinson from Vanderbilt University Medical Center, Nashville, Tennessee, told Reuters Health. "More data will be needed to adequately compare the first-night effect in different populations."

Dr. Hutchinson and colleagues compared the sleep parameters of 49 patients studied in their hotel-based laboratory and 44 studied in a hospital-based sleep facility. They predicted that the changes in sleep architecture consistent with the first-night effect would be greater in the hospital setting.

The sleep parameters for the hotel-based patients did not differ from those of the hospital-based patients. Both groups had a similar percent of sleep efficiency, sleep onset latency, REM sleep latency, slow wave sleep, arousal index, and stage 1 sleep, the report indicates.

All of the patients were being evaluated for obstructive sleep apnea and the groups did not differ significantly in their comorbid medical diagnoses or associated symptoms.

"These results counter our hypothesis that creating a more familiar environment, such as that offered by a hotel room, may reduce or eliminate the sleep architecture changes associated with the first-night effect," the researchers conclude.

"I believe that the first-night effect is more likely due to the wires and technical equipment needed to monitor sleep rather than the location of the bed," Dr. Hutchinson said. "This does not mean, however, that a more comfortable, familiar environment doesn't increase patient satisfaction."

"Ideally, patients would have two nights in the lab, one to adjust to the wires, etc. and the second for obtaining data," Dr. Hutchinson said. "Two nights for each study is impractical in the clinical setting, however. Other ideas include patients showing up early enough to become familiar with the lab and/or visiting the lab prior to the study night."

J Clin Sleep Med 2008;4:119-122.

Copyright Reuters 2008. Click for Restrictions