| Summary: | The clinical relevance of rapid eye movement sleep-related obstructive sleep apnea (REM
OSA) is supported by its associated adverse health outcomes and impact on optimal treatment
strategies. To date, no assessment of REM OSA phenotyping performance has been conducted
for any type of sleep testing technology. The objective of this study was to assess this for
polysomnography (PSG) and a peripheral arterial tone-based home sleep apnea test (PAT
HSAT).
In a dataset comprising 261 participants, the sensitivity and specificity of the agreement on
REM OSA phenotyping was assessed for two independent scorings of PSG and
synchronously administered PAT HSAT.
The sensitivity and specificity of REM OSA phenotyping were 0.87 and 0.89 respectively for
the PSG inter-scorer comparison, and 0.68 and 0.97 for PAT HSAT on a single-night basis,
using the conventional minimum required REM sleep time of 30 minutes.
PSG-based REM OSA phenotyping was found to be sensitive and specific even for a singlenight testing protocol. PAT-based REM OSA phenotyping showed a lower sensitivity but a
slightly higher specificity compared to PSG. In order to increase performance and
conclusiveness of PAT-based REM OSA phenotyping, a multi-night protocol of 2 to 5 nights
could be considered.
Finally, the minimum required REM sleep time could be lowered from the conventional 30
minutes to 15 minutes without significantly lowering REM OSA phenotyping sensitivity and
specificity while increasing the level of phenotyping conclusiveness.
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