Introduction
The use of assistive technology and telemedicine is likely to increase in developed countries [1], mainly to enhance monitoring in nursing homes, in hospital wards, and to allow data transmission from the patient's home, but also to face the increasing demand for medical investigations related with the aging of the population, the growing complexity of medical technology or to avoid patients displacement, especially when patients live far away from the hospital [2], [3].
Obstructive sleep apnea syndrome (OSA) is a growing health problem, which is now recognized as an independent risk factor for hypertension, coronary heart disease, stroke and motor vehicle accidents [4], [5], [6], [7]. The Wisconsin Sleep Cohort Study [8] found that OSA affected 2% of women and 4% of men but its prevalence, nowadays, is probably higher [9]. There is an increasing need for sleep study recordings and, despite the development of sleep medicine and sleep labs, the availability of polysomnography (PSG) remains limited in many countries [10] that face very long waiting lists.
Home sleep studies with portable monitoring (PM) devices have been proposed to decrease costs and facilitate the diagnostic process [11].
We have recently shown that home-PSG (Type 2 PM [12]) is a cost-effective alternative for the diagnosis of OSA, with a good diagnostic accuracy. It is more comfortable for the patients, whose sleep efficiency is better than in the hospital [13].
Others studies, performed with simplified portable devices, have also shown an interest in these methods for screening/diagnosis with variable results [11].
The major problem encountered with these devices is the potential loss of data, observed with polysomnographic procedures (4.7–20%) [13] as well as with polygraphic procedures (up to 24%) [14], leading to less cost-savings than expected.
The purpose of the study was to assess, in a feasibility study, whether telematic transmission using Dream® (portable polysomnographic device) and Sleepbox® technologies, with possible remote intervention, decreases home-PSG failure rate.