Monitoring noninvasive ventilation in neuromuscular patients: feasibility of unattended home polysomnography and reliability of sleep diaries

Background: In-hospital polysomnography (PSG) often is performed to monitor neuromuscular patients under noninvasive ventilation (NIV), but success of home PSG has not been established for that purpose. Reliability of sleep diaries in neuromuscular patients is unknown. The aims of our study were to evaluate feasibility, quality, and acceptability of unattended home PSG, as well as the reliability of sleep diaries in neuromuscular patients on long-term NIV. Methods: Fifty-two neuromuscular patients underwent unattended home or hospital PSG during NIV. Patients were questioned about their sleep during the PSG and their attitudes towards the procedure. Results: One home and one hospital PSG were scored as failure or low quality due to prolonged signal loss or sleep duration of <3 h. Objective and subjective sleep duration and efficiency often showed large differences. Subjective awakenings reflected objective awakenings lasting for >4 min in 86.5% patients. Preference for home PSG was expressed by 82% subjects. Conclusions: In neuromuscular patients under NIV unattended home PSG is feasible and preferred, with a low failure rate. The degree of reliability of different parameters of subjective sleep assessment should be considered when used as a complement of nocturnal cardiorespiratory recordings.