Medical technology assessment of polysomnography, type 2: Full PSG at home – Difference of two unattended PSG at home systems

Introduction Polysomnography (PSG) in a clinical setting (PSG, type 1) is time consuming and expensive. Type 2, i.e. full PSG at home, is thought to be a good alternative, but has never been evaluated in terms of a medical technology assessment (MTA). In some countries this lack of MTA precludes reimbursement for PSG type 2. This communication is part of a series of posters which add up to MTA of PSG, type 2, and deals with technical failures when recording full PSG at home. This study is designed to evaluate the technical reliability of two different full PSG systems at home, Titanium (Embla) and Siesta (Compumedics Limited). Materials and methods A retrospective study was set up for evaluation of the two full PSG systems at home. The population which used the Titanium system (T) consisted of 337 patients (age: 45 ± 17 yrs) and for Siesta (S) of 100 patients (age: 43 ± 17 yrs). Patients underwent for two consecutive days type 2 PSG at home with one system. After 24 h, patients returned to the clinic for a check-up. The following signals were evaluated within both systems: EEG (including eye movements and chin EMG), EMGm.tibialis, nasal pressure, inductive beltsthorax and abdomen, and oxygen saturation. Failure was indicated when there was limited recording time or due to technical interruptions. We also estimated the amount of interruption within the recorded signals. Results Both systems were similar in percentages of patients without any failures in both nights (T:92.9%; S:90.0%, p  = 0.34). The T-system failed in 3.9% on the first, and 3.0% on the second night. During one recording (0.3%) both nights failed. Failures within the first and second night (5.0%) were similar in the S-system and there were no recordings with failures in both nights. Within the successful recordings there were more saturation and inductive belts interruptions of the S-system. This resulted for saturation in T:22.5% and S:35.1% ( p  = 0.01) and the inductive belts T:3.7% and S:10.0% ( p  = 0.02). Conclusion It is reliable to perform full PSG type 2 at home with both PSG systems. To minimize the errors in particular for saturation, there is a preference for the Titanium system. Despite the failures, all diagnoses could be made.