Are type III devices the future of sleep disordered breathing management?

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The high prevalence of undiagnosed sleep disordered breathing (SDB), and its health consequences, require improved routine screening, assessment and diagnosis. The sleep study is the most important investigation in the process of making the diagnosis of SDB [1]. Typically, there are three major types of sleep studies: full polysomnography, respiratory polygraphy and overnight oximetry. These three types of nocturnal recording have been classified as type I (attended full polysomnography), type II (unattended full polysomnography), type III (respiratory polygraphy or equivalent), and type IV (devices that measure only one or two parameters, typically oxygen saturation and heart rate or, in some cases, just airflow) [2]. Polysomnography is still regarded as the diagnostic gold standard and usually includes assessment of oximetry, snoring, body and leg movements, nasal pressure as a surrogate for nasal airflow, mouth breathing via a thermistor, and excursion of the chest and abdomen, as well as an electrocardiogram, electroencephalogram, electrooculogram and electromyogram to identify sleep stages. Respiratory polygraphy usually includes all these assessments but without an electroencephalogram, electrooculogram or electromyogram.