0587 Convenience vs Accuracy: Negative Predictability of the Home Sleep Test in Clinical Practice

Abstract Introduction Sleep apnea is a serious disorder associated with numerous health conditions. In clinical practice, providers order screening home sleep testing (HST) for obstructive sleep apnea (OSA); however, there is limited research about the negative predictive value (NPV) and false negative rate of this test. Providers may not understand HST limitations; therefore, what is the NPV and false negative rate in clinical practice? Methods A retrospective study of non-diagnostic HST is conducted in a Northeastern US rural community sleep clinic. The study population includes adult patients ≥ 18 years old who underwent HST from 2016-2019. The non-diagnostic HST result is compared to the gold standard, the patient’s nocturnal polysomnogram (NPSG). The results provide the NPV (true negative/total) and false negative (true positive/total) for the non-diagnostic HST. Results We identified 211 potential patients with a mean age of 43 years, of which 67% were female. Of those, 85% (n=179) underwent NPSG, with the others declining/delaying testing or lost to follow up. The non-diagnostic HST showed 15.6% NPV for no apnea using AHI