Abstract
For over three decades, Type III devices have been used in the diagnosis of sleep disordered breathing in supervised as well as unsupervised settings. They have satisfactory positive and negative predictive values for detecting obstructive and central sleep apnoea in populations with moderately-high pre-test probability of symptoms associated with these events. However, standardisation of commercially available Type III devices has never been undertaken and the technical specifications can vary widely. None have been subjected to the same rigorous processes as most other diagnostic modalities in the medical field. Although Type III devices do not include acquisition of electroencephalographic signals overnight, the minimum number of physical sensors required to allow for respiratory event scoring using standards outlined by the American Academy of Sleep Medicine remains debatable. This Technical Standard summarises data on Type III studies published since 2007 from multiple perspectives in both adult and paediatric sleep practice. Most importantly, it aims to provide a framework for considering current Type III device limitations in the diagnosis of sleep disordered breathing whilst raising research and practice-related questions aimed at improving our use of these devices in the present and future.
Footnotes
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Conflict of interest: Renata L Riha reports one-off personal speaker fees and participation on an advisory board from Jazz Pharmaceuticals. Renata Riha is also co-director of Sleep Consultancy Ltd.
Conflict of interest: Martina Celmina reports lecture honoraria from Rare diseases conference, Latvian Medical Association; support to attend various conferences (IPSA, Baltic Sleep Meeting, Nordic Sleep Meeting) provided by Children's Clinical University Hospital (Riga, Latvia); and is Member of the board – Latvian Sleep Medicine Society.
Conflict of interest: Brendan Cooper, Refika Hamutcu-Ersu, Athanasios Kaditis, Athanasia Pataka, Annelies Van Eyck have no conflict of interest to disclose related to the topic discussed in this Technical Standard.
Conflict of interest: Refika Hamutcu-Ersu
Conflict of interest: Athanasios Kaditis
Conflict of interest: Andrew Morley reports lecture honoraria from Sleep consultancy ltd and Sleep Scotland; participation on advisory board for BTS Guideline for Pediatric Sleep Disorders; and is a board member of Association of Respiratory Technology & Physiology – Sleep.
Conflict of interest: Athanasia Pataka
Conflict of interest: Thomas Penzel reports personal speaker fees from Cerebra, Jazz Pharma, Löwenstein Medical, National Sleep Foundation, Neuwirth; consulting fees from Bayer Healthcare, Cerebra; travel support from Jazz Pharma, Nukute; participation on advisory boards for Nukute, Cerebra; stock or stock options with The Siestagroup, Nukute, Advanced Sleep Research; receipt of equipment from Neurovirtual; institutional fees and research grants from Bayer Healthcare, Cidelec, Löwenstein Medical, Novartis, and Springer Publisher. Thomas Penzel also reports the following leadership roles: German Sleep Society (President, unpaid), IEEE Engineering in Medicine and Biology (Adcom member, unpaid), German Society on Biomedical Engineering (Board member, unpaid), DIN – German standardization body (Committee member, unpaid).
Conflict of interest: Luca Roberti reports grants Resmed, Fisher & Paykel, Jazz Ph, Bioprojet, Vitalaire, Linde, Medicair, Philips, Olympus, Respiraire, Vivisol. Luca Roberti also reports the following leadership roles: President of Associazione Apnoici Italiani APS (Italian Sleep Apnoea Patient Association); Sleep Apnoea Patient Representative of EMA, Member of ELF Sleep Apnoea PAG.
Conflict of interest: Warren Ruehland reports travel support from Institute for Breathing and Sleep to attend Sleep Downunder and TSANZSRS Conferences, and from Australian and New Zealand Sleep Science Association to attend Sleep Downunder conference. Warren Ruehland reports the following leadership roles: Board member Australian and New Zealand Sleep Science Association, Committee member of Medical and Scientific Research Committee, Institute for Breathing and Sleep, Director of Respiratory Quality Assurance Pty Ltd – provides PSG scoring external proficiency testing program (QSleep) for sleep centres.
Conflict of interest: Dries Testelmans reports institutional fees and educational grants from AirLiquide, Philips Respironics and Resmed.
Conflict of interest: Annelies van Eyck
Conflict of interest: Gert Grundström is Chairman of The Swedish Sleepapnea Association.
Conflict of interest: Johan Verbraecken reports institutional fees and educational grants from Accuramed, Agfa-Gevaert, AirLiquide, AstraZen, Bekaert Deslee Academy, Bioprojet, Desitin, Ectosense, Fisher & Paykel, Heinen & Löwenstein, Idorsia, Inspire, Jazz Pharmaceutics, Medidis, Mediq Tefa, MSD, NightBalance, OSA Academy, OSG, Oxford Pharmagenesis, Philips Respironics, ResMed, Sanofi, SomnoMed, Springer, Total Care, UCB Pharma, Vivisol, Wave Medical, and Westfalen Medical; consulting fees from Vermedia. Johan Verbraecken reports the following leadership roles: President (up to 8/2021) and past president Belgian Association for Sleep research and Sleep medicine (since 9/2021).
Conflict of interest: Winfried Randerath reports institutional fees, research grants and speaking fees from Philips Respironics, Heinen&Löwenstein, Jazz Pharmaceuticals, Weinmann, Resmed, Inspire, Vanda Pharma and Bioprojet. Winfried Randerath is European Respiratory Society Head Assembly 4, Sleep Disordered Breathing.
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- Received February 25, 2022.
- Accepted July 27, 2022.
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