Affiliations: [a] Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA | [b] Department of Medicine, John Hopkins School of Medicine, Baltimore, MD, USA | [c] The Shepherd Center, Atlanta, GA, USA
Correspondence:
[*]
Address for correspondence: William Lu, 1 Gustave L. Levy Place, Box 1163, New York, NY 10029, USA.
Tel.: +1 212 241 5190; Fax: +1 212 348 5901; E-mail: william.lu@mountsinai.org
Abstract: Background:Obstructive sleep apnea (OSA) is commonly found in individuals with traumatic brain injury (TBI) and may exacerbate TBI-related symptoms. Nocturnal polysomnography (NPSG) is considered the gold standard for detecting the presence of sleep apnea. However, there is a limitation with its use known as the “first-night effect” (aberrant polysomnography findings on the first night in a sleep lab). Objective:The primary objectives were to investigate the night-to-night consistency of diagnosing and classifying obstructive sleep apnea in individuals with TBI, and ascertain if individuals with TBI are prone to a first-night effect. Methods:47 community-dwelling adults with self-reported mild-to-severe TBI underwent two nights of in-laboratory NPSG to examine variability between the first and second night with regards to OSA diagnosis and severity as well as sleep architecture. Results:OSA detection and severity were consistent from night-to-night in 89% of participants with TBI. Participants with TBI demonstrated longer REM latency on the first night compared to the second night of sleep study. Conclusions:These findings indicate that two nights of in-laboratory NPSG are generally consistent in reliably diagnosing OSA in individuals with TBI and that first-night effects are minimal. One night of NPSG has diagnostic utility in the evaluation of sleep disorders in individuals with TBI.
