What is the role of ambulatory monitors in the workup of sleep-disordered breathing (SDB)?

Answer

Home sleep testing pursues the goal of simplify the diagnosis of sleep apnea while retaining the essential recording features of PSG. There is some evidence to suggest that home sleep studies have benefits in terms of time and cost, but for diagnostic reliability, an in-laboratory sleep study may be required in more than half of the cases.

Various types of ambulatory (to be used at home) monitors can measure parameters such as airflow, chest, and abdomen movements (as indicators of respiratory effort); oxygen desaturations; snoring; pulse; and body position.^{[52, 53]}

Although the data from such studies are not as detailed or accurate as those obtained from an overnight PSG, these studies can often be used to differentiate primary snoring from snoring with apneas and can usually provide an indication of the frequency with which apneas are occurring. In contrast, techniques that measure only one parameter (eg, home oximetry alone) seem to be less accurate than those that track several measurements.

EdenTrace portable monitor measures nasal and oral air flow using thermistors, chest wall impedance, oxygen saturation with finger pulse oximetry, heart rate, and movement detected by electrical comparison of the signals from electrocardiography and pulse oximetry.

The MESAM IV system evaluates SDB on the basis of analysis of snoring, heart rate, and saturation change. Even if in many studies there is a good agreement between the RDI measured in the laboratory and that measure with home sleep testing, there is a risk that ambulatory diagnostic procedures may alter patients' relationship with their disease, the medical staff, or both in such a way that their subsequent compliance with treatment may be decreased.

The Nightwatch system has the ability to calculate the RDI. It records eye movement (one channel, piezo electrode), leg movement (one channel, piezo electrode), (finger pulse oximeter), nasal oral airflow (thermistor), chest and abdominal movements (piezo electrodes), body position and movement (mercury gauge placed on the chest), and heart rate.

The Nightwatch system also has the ability to send 2-minute portions of the complete recording to the laboratory for analysis so that signal quality can be assessed and transducer function corrected if necessary. However, further studies are necessary before this technology can be put into widespread use.

With the aim of developing a simpler, cheaper, and more accessible method for the diagnosis of OSAS, the peripheral arterial tonometer (PAT) has been proposed for use in ambulatory diagnosis of OSAS. The portable monitoring device WatchPAT 200 detects obstructive events by identifying the changes in sympathetic activity associated with the termination of the events. The wrist-worn device WatchPAT 200, compared with standard PSG, has been reported to be able to detect OSAS on the basis of the RDI with comparable accuracy.^[54]

Did this answer your question?

Yes No

Additional feedback? (Optional)

Thank you for your feedback!

Findley L, Unverzagt M, Guchu R, Fabrizio M, Buckner J, Suratt P. Vigilance and automobile accidents in patients with sleep apnea or narcolepsy. Chest. 1995 Sep. 108(3):619-24. [Medline].
Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J. The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med. 1999 Mar 18. 340(11):847-51. [Medline].
Caples SM, Gami AS, Somers VK. Obstructive sleep apnea. Ann Intern Med. 2005 Feb 1. 142 (3):187-97. [Medline].
Eastwood PR, Malhotra A, Palmer LJ, Kezirian EJ, Horner RL, Ip MS, et al. Obstructive Sleep Apnoea: From pathogenesis to treatment: Current controversies and future directions. Respirology. 2010 May. 15(4):587-95. [Medline].
Flemons WW. Clinical practice. Obstructive sleep apnea. N Engl J Med. 2002 Aug 15. 347(7):498-504. [Medline].
George CF. Diagnostic techniques in obstructive sleep apnea. Prog Cardiovasc Dis. 1999 Mar-Apr. 41(5):355-66. [Medline].
Thakkar K, Yao M. Diagnostic studies in obstructive sleep apnea. Otolaryngol Clin North Am. 2007 Aug. 40(4):785-805. [Medline].
Saletu M, Sauter C, Lalouschek W, Saletu B, Kapfhammer G, Benesch T, et al. Is excessive daytime sleepiness a predictor of carotid atherosclerosis in sleep apnea?. Atherosclerosis. 2008 Feb. 196(2):810-6. [Medline].
Acar M, Yazıcı D, Bayar Muluk N, Hancı D, Seren E, Cingi C. Is There a Relationship Between Snoring Sound Intensity and Frequency and OSAS Severity?. Ann Otol Rhinol Laryngol. 2016 Jan. 125 (1):31-6. [Medline].
Exar EN, Collop NA. The upper airway resistance syndrome. Chest. 1999 Apr. 115(4):1127-39. [Medline].
Hudgel DW, Hendricks C, Hamilton HB. Characteristics of the upper airway pressure-flow relationship during sleep. J Appl Physiol. 1988 May. 64(5):1930-5. [Medline].
He J, Kryger MH, Zorick FJ, Conway W, Roth T. Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. Chest. 1988 Jul. 94(1):9-14. [Medline].
Remmers JE, deGroot WJ, Sauerland EK, Anch AM. Pathogenesis of upper airway occlusion during sleep. J Appl Physiol. 1978 Jun. 44(6):931-8. [Medline].
Casale M, Rinaldi V, Bressi F, Di Peco V, Baptista P, Sadun B, et al. A suitable test for identifying high risk adult patients of moderate-severe obstructive sleep apnea syndrome. Eur Rev Med Pharmacol Sci. 2008 Jul-Aug. 12(4):275-80. [Medline].
Casale M, Pappacena M, Rinaldi V, Bressi F, Baptista P, Salvinelli F. Obstructive sleep apnea syndrome: from phenotype to genetic basis. Curr Genomics. 2009 Apr. 10(2):119-26. [Medline]. [Full Text].
Bekci TT, Kocak N, Kesli R. Distribution of common methylenetetrahydrofolate reductase gene mutations in patients with obstructive sleep apnoea. J Int Med Res. 2009 Nov-Dec. 37(6):1718-24. [Medline].
Manzotte T, Guindalini C, Mazzotti DR, Palombini L, de Souza AL, Poyares D, et al. The human leucocyte antigen DQB1*0602 allele is associated with electroencephelograph differences in individuals with obstructive sleep apnoea syndrome. J Sleep Res. 2013 Apr. 22 (2):217-22. [Medline].
de Carvalho TB, Suman M, Molina FD, Piatto VB, Maniglia JV. Relationship of obstructive sleep apnea syndrome with the 5-HT2A receptor gene in Brazilian patients. Sleep Breath. 2013 Mar. 17 (1):57-62. [Medline].
de Lima FF, Mazzotti DR, Tufik S, Bittencourt L. The role inflammatory response genes in obstructive sleep apnea syndrome: a review. Sleep Breath. 2016 Mar. 20 (1):331-8. [Medline].
O'Connor C, Thornley KS, Hanly PJ. Gender differences in the polysomnographic features of obstructive sleep apnea. Am J Respir Crit Care Med. 2000 May. 161 (5):1465-72. [Medline].
Roever L, Quan SF. Prevalence of Sleep Disordered Breathing Symptoms and Risk Factors for Chronic Diseases: Are There Differences in Countries of High and Low Income?. Sleep. 2015 Sep 1. 38 (9):1349-50. [Medline].
Jordan AS, McEvoy RD. Gender differences in sleep apnea: epidemiology, clinical presentation and pathogenic mechanisms. Sleep Med Rev. 2003 Oct. 7(5):377-89. [Medline].
Mohsenin V. Effects of gender on upper airway collapsibility and severity of obstructive sleep apnea. Sleep Med. 2003 Nov. 4(6):523-9. [Medline].
Young T, Shahar E, Nieto FJ, Redline S, Newman AB, Gottlieb DJ, et al. Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med. 2002 Apr 22. 162(8):893-900. [Medline].
Campos-Rodriguez F, Perez-Ronchel J, Grilo-Reina A, Lima-Alvarez J, Benitez MA, Almeida-Gonzalez C. Long-term effect of continuous positive airway pressure on BP in patients with hypertension and sleep apnea. Chest. 2007 Dec. 132(6):1847-52. [Medline].
Chowdhury M, Adams S, Whellan DJ. Sleep-disordered breathing and heart failure: focus on obstructive sleep apnea and treatment with continuous positive airway pressure. J Card Fail. 2010 Feb. 16(2):164-74. [Medline].
Fletcher EC. Can the treatment of sleep apnea syndrome prevent the cardiovascular consequences?. Sleep. 1996 Nov. 19(9 Suppl):S67-70. [Medline].
Haruki N, Takeuchi M, Kanazawa Y, Tsubota N, Shintome R, Nakai H, et al. Continuous positive airway pressure ameliorates sleep-induced subclinical left ventricular systolic dysfunction: demonstration by two-dimensional speckle-tracking echocardiography. Eur J Echocardiogr. 2010 May. 11(4):352-8. [Medline].
Wolf J, Lewicka J, Narkiewicz K. Obstructive sleep apnea: an update on mechanisms and cardiovascular consequences. Nutr Metab Cardiovasc Dis. 2007 Mar. 17(3):233-40. [Medline].
Chami HA, Fontes JD, Vasan RS, Keaney JF Jr, O'Connor GT, Larson MG, et al. Vascular inflammation and sleep disordered breathing in a community-based cohort. Sleep. 2013 May 1. 36 (5):763-768C. [Medline].
Oliveras A, Schmieder RE. Clinical situations associated with difficult-to-control hypertension. J Hypertens. 2013 Mar. 31 Suppl 1:S3-8. [Medline].
Toraldo DM, De Benedetto M, Scoditti E, De Nuccio F. Obstructive sleep apnea syndrome: coagulation anomalies and treatment with continuous positive airway pressure. Sleep Breath. 2016 May. 20 (2):457-65. [Medline].
Tsai M, Khayat R. Sleep Apnea in Heart Failure. Curr Treat Options Cardiovasc Med. 2018 Mar 22. 20 (4):33. [Medline].
Cho ER, Kim H, Seo HS, Suh S, Lee SK, Shin C. Obstructive sleep apnea as a risk factor for silent cerebral infarction. J Sleep Res. 2013 Aug. 22 (4):452-8. [Medline].
Gupta A, Shukla G, Afsar M, Poornima S, Pandey RM, Goyal V, et al. Role of Positive Airway Pressure Therapy for Obstructive Sleep Apnea in Patients With Stroke: A Randomized Controlled Trial. J Clin Sleep Med. 2018 Apr 15. 14 (4):511-521. [Medline].
Young T, Blustein J, Finn L, Palta M. Sleep-disordered breathing and motor vehicle accidents in a population-based sample of employed adults. Sleep. 1997 Aug. 20(8):608-13. [Medline].
Harsch IA, Schahin SP, Radespiel-Troger M, Weintz O, Jahreiss H, Fuchs FS, et al. Continuous positive airway pressure treatment rapidly improves insulin sensitivity in patients with obstructive sleep apnea syndrome. Am J Respir Crit Care Med. 2004 Jan 15. 169(2):156-62. [Medline].
Hassaballa HA, Tulaimat A, Herdegen JJ, Mokhlesi B. The effect of continuous positive airway pressure on glucose control in diabetic patients with severe obstructive sleep apnea. Sleep Breath. 2005 Dec. 9(4):176-80. [Medline].
Ip M, Mokhlesi B. Sleep and Glucose Intolerance/Diabetes Mellitus. Sleep Med Clin. 2007. 2 (1):19-29. [Medline]. [Full Text].
Babu AR, Herdegen J, Fogelfeld L, Shott S, Mazzone T. Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea. Arch Intern Med. 2005 Feb 28. 165(4):447-52. [Medline].
Reichmuth KJ, Austin D, Skatrud JB, Young T. Association of sleep apnea and type II diabetes: a population-based study. Am J Respir Crit Care Med. 2005 Dec 15. 172(12):1590-5. [Medline]. [Full Text].
Sadikot SM. An overview: Obstructive sleep apnea and the metabolic syndrome: Should ‘‘X’’ be changed to ‘‘Zzz. . zzzz. . Zzzz zzzzz. .Zzz’’?. Diabetes Metab Syndrome. 2007. 1 (4):287-302.
Misiolek M, Marek B, Namyslowski G, Scierski W, Zwirska-Korczala K, Kazmierczak-Zagorska Z, et al. Sleep apnea syndrome and snoring in patients with hypothyroidism with relation to overweight. J Physiol Pharmacol. 2007 Mar. 58 Suppl 1:77-85. [Medline].
Hoban TF. Sleep disorders in children. Ann N Y Acad Sci. 2010 Jan. 1184:1-14. [Medline].
Ciscar MA, Juan G, Martínez V, Ramon M, Lloret T, Mínguez J, et al. Magnetic resonance imaging of the pharynx in OSA patients and healthy subjects. Eur Respir J. 2001 Jan. 17(1):79-86. [Medline].
Fry JM, DiPhillipo MA, Curran K, Goldberg R, Baran AS. Full polysomnography in the home. Sleep. 1998 Sep 15. 21(6):635-42. [Medline].
Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med. 2000 Feb 1. 1(1):21-32. [Medline].
Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999 Oct 5. 131(7):485-91. [Medline].
Ohayon MM, Guilleminault C, Priest RG, Caulet M. Snoring and breathing pauses during sleep: telephone interview survey of a United Kingdom population sample. BMJ. 1997 Mar 22. 314(7084):860-3. [Medline]. [Full Text].
Roth T, Zammit G, Kushida C, Doghramji K, Mathias SD, Wong JM, et al. A new questionnaire to detect sleep disorders. Sleep Med. 2002 Mar. 3(2):99-108. [Medline].
Abrishami A, Khajehdehi A, Chung F. A systematic review of screening questionnaires for obstructive sleep apnea. Can J Anaesth. 2010 May. 57(5):423-38. [Medline].
Emsellem HA, Corson WA, Rappaport BA, Hackett S, Smith LG, Hausfeld JN. Verification of sleep apnea using a portable sleep apnea screening device. South Med J. 1990 Jul. 83(7):748-52. [Medline].
Stoohs R, Guilleminault C. MESAM 4: an ambulatory device for the detection of patients at risk for obstructive sleep apnea syndrome (OSAS). Chest. 1992 May. 101(5):1221-7. [Medline].
Weimin L, Rongguang W, Dongyan H, Xiaoli L, Wei J, Shiming Y. Assessment of a portable monitoring device WatchPAT 200 in the diagnosis of obstructive sleep apnea. Eur Arch Otorhinolaryngol. 2013 Nov. 270 (12):3099-105. [Medline].
Fishman G, Zemel M, DeRowe A, Sadot E, Sivan Y, Koltai PJ. Fiber-optic sleep endoscopy in children with persistent obstructive sleep apnea: inter-observer correlation and comparison with awake endoscopy. Int J Pediatr Otorhinolaryngol. 2013 May. 77 (5):752-5. [Medline].
Campanini A, Canzi P, De Vito A, Dallan I, Montevecchi F, Vicini C. Awake versus sleep endoscopy: personal experience in 250 OSAHS patients. Acta Otorhinolaryngol Ital. 2010 Apr. 30 (2):73-7. [Medline].
Vicini C, De Vito A, Benazzo M, Frassineti S, Campanini A, Frasconi P, et al. The nose oropharynx hypopharynx and larynx (NOHL) classification: a new system of diagnostic standardized examination for OSAHS patients. Eur Arch Otorhinolaryngol. 2012 Apr. 269 (4):1297-300. [Medline].
Berger G, Gilbey P, Hammel I, Ophir D. Histopathology of the uvula and the soft palate in patients with mild, moderate, and severe obstructive sleep apnea. Laryngoscope. 2002 Feb. 112(2):357-63. [Medline].
Namyslowski G, Scierski W, Zembala-Nozynska E, Nozynski J, Misiolek M. [Histopathologic changes of the soft palate in snoring and obstructive sleep apnea syndrome patients]. Otolaryngol Pol. 2005. 59(1):13-9. [Medline].
Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA. 2000 Dec 20. 284(23):3015-21. [Medline].
Victor LD. Treatment of obstructive sleep apnea in primary care. Am Fam Physician. 2004 Feb 1. 69(3):561-8. [Medline].
de Britto Teixeira AO, Abi-Ramia LB, de Oliveira Almeida MA. Treatment of obstructive sleep apnea with oral appliances. Prog Orthod. 2013 May 23. 14:10. [Medline].
Knappe SW, Sonnesen L. Mandibular positioning techniques to improve sleep quality in patients with obstructive sleep apnea: current perspectives. Nat Sci Sleep. 2018. 10:65-72. [Medline]. [Full Text].
Chan AS, Lee RW, Cistulli PA. Dental appliance treatment for obstructive sleep apnea. Chest. 2007 Aug. 132 (2):693-9. [Medline].
Souter MA, Stevenson S, Sparks B, Drennan C. Upper airway surgery benefits patients with obstructive sleep apnoea who cannot tolerate nasal continuous positive airway pressure. J Laryngol Otol. 2004 Apr. 118(4):270-4. [Medline].
Aloia MS, Stanchina M, Arnedt JT, Malhotra A, Millman RP. Treatment adherence and outcomes in flexible vs standard continuous positive airway pressure therapy. Chest. 2005 Jun. 127(6):2085-93. [Medline]. [Full Text].
Berkani M, Lofaso F, Chouaid C, Pia d'Ortho M, Theret D, Grillier-Lanoir V, et al. CPAP titration by an auto-CPAP device based on snoring detection: a clinical trial and economic considerations. Eur Respir J. 1998 Oct. 12(4):759-63. [Medline].
Douglas NJ. Systematic review of the efficacy of nasal CPAP. Thorax. 1998 May. 53(5):414-5. [Medline]. [Full Text].
Fleisher KE, Krieger AC. Current trends in the treatment of obstructive sleep apnea. J Oral Maxillofac Surg. 2007 Oct. 65(10):2056-68. [Medline].
Grunstein RR. Sleep-related breathing disorders. 5. Nasal continuous positive airway pressure treatment for obstructive sleep apnoea. Thorax. 1995 Oct. 50(10):1106-13. [Medline]. [Full Text].
Kawahara S, Akashiba T, Akahoshi T, Horie T. Nasal CPAP improves the quality of life and lessens the depressive symptoms in patients with obstructive sleep apnea syndrome. Intern Med. 2005 May. 44 (5):422-7. [Medline].
Lankford DA, Proctor CD, Richard R. Continuous positive airway pressure (CPAP) changes in bariatric surgery patients undergoing rapid weight loss. Obes Surg. 2005 Mar. 15(3):336-41. [Medline].
McArdle N, Devereux G, Heidarnejad H, Engleman HM, Mackay TW, Douglas NJ. Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med. 1999 Apr. 159(4 Pt 1):1108-14. [Medline].
Ryan S, McNicholas W. The effect of continuous positive airway pressure on C-reactive protein levels in patients with obstructive sleep apnea syndrome. Chest. 2010 Feb. 137(2):496-7; author reply 497-8. [Medline].
Schwartz DJ, Kohler WC, Karatinos G. Symptoms of depression in individuals with obstructive sleep apnea may be amenable to treatment with continuous positive airway pressure. Chest. 2005 Sep. 128(3):1304-9. [Medline].
Stammnitz A, Jerrentrup A, Penzel T, Peter JH, Vogelmeier C, Becker HF. Automatic CPAP titration with different self-setting devices in patients with obstructive sleep apnoea. Eur Respir J. 2004 Aug. 24(2):273-8. [Medline].
Stradling JR, Hardinge M, Smith DM. A novel, simplified approach to starting nasal CPAP therapy in OSA. Respir Med. 2004 Feb. 98(2):155-8. [Medline].
Teschler H, Berthon-Jones M. Intelligent CPAP systems: clinical experience. Thorax. 1998 Oct. 53 Suppl 3:S49-54. [Medline]. [Full Text].
Weaver TE, Kribbs NB, Pack AI, Kline LR, Chugh DK, Maislin G, et al. Night-to-night variability in CPAP use over the first three months of treatment. Sleep. 1997 Apr. 20(4):278-83. [Medline].
Levy P, Pepin JL. Auto-CPAP: an effective and low-cost procedure in the management of OSAS?. Eur Respir J. 1998 Oct. 12(4):753-5. [Medline].
Morgenthaler TI, Aurora RN, Brown T, Zak R, Alessi C, Boehlecke B, et al. Practice parameters for the use of autotitrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome: an update for 2007. An American Academy of Sleep Medicine report. Sleep. 2008 Jan 1. 31(1):141-7. [Medline]. [Full Text].
Doherty LS, Kiely JL, Lawless G, McNicholas WT. Impact of nasal continuous positive airway pressure therapy on the quality of life of bed partners of patients with obstructive sleep apnea syndrome. Chest. 2003 Dec. 124(6):2209-14. [Medline].
Flemons WW, Tsai W. Quality of life consequences of sleep-disordered breathing. J Allergy Clin Immunol. 1997 Feb. 99(2):S750-6. [Medline].
Moyer CA, Sonnad SS, Garetz SL, Helman JI, Chervin RD. Quality of life in obstructive sleep apnea: a systematic review of the literature. Sleep Med. 2001 Nov. 2(6):477-91. [Medline].
Ciftci TU, Ciftci B, Guven SF, Kokturk O, Turktas H. Effect of nasal continuous positive airway pressure in uncontrolled nocturnal asthmatic patients with obstructive sleep apnea syndrome. Respir Med. 2005 May. 99(5):529-34. [Medline].
Stradling JR, Smith D, Crosby J. Post-CPAP sleepiness--a specific syndrome?. J Sleep Res. 2007 Dec. 16(4):436-8. [Medline].
Shiina K, Tomiyama H, Takata Y, Yoshida M, Kato K, Saruhara H, et al. Effects of CPAP therapy on the sympathovagal balance and arterial stiffness in obstructive sleep apnea. Respir Med. 2010 Jun. 104(6):911-6. [Medline].
Jean Wiese H, Boethel C, Phillips B, Wilson JF, Peters J, Viggiano T. CPAP compliance: video education may help!. Sleep Med. 2005 Mar. 6(2):171-4. [Medline].
Marshall NS, Neill AM, Campbell AJ, Sheppard DS. Randomised controlled crossover trial of humidified continuous positive airway pressure in mild obstructive sleep apnoea. Thorax. 2005 May. 60(5):427-32. [Medline]. [Full Text].
Neill AM, Wai HS, Bannan SP, Beasley CR, Weatherall M, Campbell AJ. Humidified nasal continuous positive airway pressure in obstructive sleep apnoea. Eur Respir J. 2003 Aug. 22(2):258-62. [Medline].
Bachour A, Hurmerinta K, Maasilta P. Mouth closing device (chinstrap) reduces mouth leak during nasal CPAP. Sleep Med. 2004 May. 5(3):261-7. [Medline].
McEachern RC, Patel RG. Pneumopericardium associated with face-mask continuous positive airway pressure. Chest. 1997 Nov 5. 112(5):1441-3. [Medline].
Eskandari D, Zou D, Grote L, Hoff E, Hedner J. Acetazolamide Reduces Blood Pressure and Sleep-Disordered Breathing in Patients With Hypertension and Obstructive Sleep Apnea: A Randomized Controlled Trial. J Clin Sleep Med. 2018 Mar 15. 14 (3):309-317. [Medline].
Mantovani M, Rinaldi V, Torretta S, Carioli D, Salamanca F, Pignataro L. Barbed Roman blinds technique for the treatment of obstructive sleep apnea: how we do it?. Eur Arch Otorhinolaryngol. 2016 Feb. 273 (2):517-23. [Medline].
Mantovani M, Rinaldi V, Salamanca F, Torretta S, Carioli D, Gaffuri M, et al. Should we stop performing uvulopalatopharyngoplasty?. Indian J Otolaryngol Head Neck Surg. 2015 Mar. 67 (Suppl 1):161-2. [Medline].

Media Gallery

CPAP machine.

of 1

Author

Vittorio Rinaldi, MD Specialist in Otolaryngology, Division of Otolaryngology, Department of Clinical Sciences and Community Health, University of Milan, Fondazione I.R.C.C.S. Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy

Disclosure: Nothing to disclose.

Coauthor(s)

Andrea Costantino, MS Campus Bio-Medico University of Rome, Italy

Disclosure: Nothing to disclose.

Alberto Luchena Campus Bio-Medico University of Rome, Italy

Disclosure: Nothing to disclose.

Lorenzo Sabatino, MD Resident Physician, Unit of Otolaryngology, Campus Bio-Medico University of Rome, Italy

Disclosure: Nothing to disclose.

Manuele Casale, MD Specialist in Otolaryngology, Campus Bio-Medico, University of Rome School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Robert M Kellman, MD Professor and Chair, Department of Otolaryngology and Communication Sciences, State University of New York Upstate Medical University

Robert M Kellman, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Head and Neck Society, American Rhinologic Society, Triological Society, American Neurotology Society, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, Medical Society of the State of New York

Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD, FACP, FCCP Geri and Richard Brawerman Chair in Pulmonary and Critical Care Medicine, Professor and Executive Vice Chairman, Department of Medicine, Medical Director, Women's Guild Lung Institute, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Zab Mosenifar, MD, FACP, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Thoracic Society

Disclosure: Nothing to disclose.

Additional Contributors

Jack A Coleman, MD Consulting Staff, Franklin Surgical Associates

Jack A Coleman, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Sleep Medicine, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American Bronchoesophagological Association, American College of Surgeons, The Triological Society, American Society for Laser Medicine and Surgery, Association of Military Surgeons of the US

Disclosure: Received honoraria from Accarent, Inc. for speaking and teaching.

Fabrizio Salvinelli, MD Professor of Otolaryngology, Campus Bio-Medico, University of Rome

Disclosure: Nothing to disclose.

Francesco Faiella, MD Resident in Otolaryngology, Campus Bio-Medico University of Rome School of Medicine

Disclosure: Nothing to disclose.

Marco Pappacena, MD Resident, Department of Otolaryngology, Campus Bio-Medico University, Rome

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Karen Hall Calhoun, MD, to the development and writing of the source article

The first author, Vittorio Rinaldi, gratefully thanks Prof P.G.Visvanathan for having introduced him to snoring and OSA surgical management.

What is the role of ambulatory monitors in the workup of sleep-disordered breathing (SDB)?

Related Questions:

References

Tables

Contributor Information and Disclosures