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Title: Accuracy of Patient Perception of Supine Sleep.
Austin Authors: Wallbridge, Peter D ;Churchward, Thomas J ;Worsnop, Christopher J 
Affiliation: Respiratory and Sleep Medicine
Institute for Breathing and Sleep
Issue Date: 15-Jul-2018
Date: 2018-07-15
Publication information: Journal of Clinical Sleep Medicine : JCSM : official publication of the American Academy of Sleep Medicine 2018; 14(7): 1205-1208
Abstract: For clinicians involved in investigating and treating sleep disorders, understanding the accuracy of patient recall of supine sleep would allow informed comparisons between polysomnography (PSG) and patient-reported sleep in patients with supine-predominant obstructive sleep apnea. This study aims to assess the accuracy of patient perception of supine sleep. Prospective observational cohort study, assessing patient perception of total sleep and supine sleep, including duration. Data were analyzed utilizing descriptive statistics, bias-plot (Bland-Altman) analysis, and Spearman correlation (rs) to analyze relationships among continuous data. Total number of patients who underwent PSG was 518, with data from 368 of these patients analyzed. Most of these patients underwent diagnostic PSG (49.2%). Patients were excluded because of missing or incomplete data (n = 133) or immobility (n = 17). Some patients (n = 97, 26%) did not perceive supine sleep, with 34 (35% of those with unperceived supine sleep or 9% of whole group) of these having more than 60 minutes of PSG supine sleep (range 0-305.5 minutes). All "unsure" patients (n = 8, 2.2%) had significant supine sleep recorded (31.5-257.5 minutes). For the presence of any PSG supine sleep, questioning had a sensitivity of 77.9%, specificity 72.7% with positive predictive value of 96.7% and negative predictive value of 24.5%. There was a significant correlation (rs = 0.63, P < .0001) between perceived and PSG supine sleep, but wide limits of agreement (-246.9 to 194.2 minutes). In patients undergoing in-laboratory PSG, the perception of supine sleep predicts the presence of PSG supine sleep. However, questioning patients has a poor negative predictive value and patient estimates of supine sleep duration are inaccurate.
DOI: 10.5664/jcsm.7226
ORCID: 0000-0003-1471-9318
Journal: Journal of Clinical Sleep Medicine : JCSM
PubMed URL: 29991424
Type: Journal Article
Subjects: accuracy
obstructive sleep apnea
patient perception
sleep position
sleep-disordered breathing
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