The Baby, the Bathwater, and the Polysomnogram

Malhotra and Ayas discuss the article by Donovan and Patel on the utility of the polysomnogram (PSG). They state that they are also strong believers in technological innovation and that optimizing patient care in obstructive sleep apnea (OSA) will require approaches that are portable, scalable, and cost effective. However, they offer several counter arguments to their colleagues for consideration. They add that they welcome a discussion regarding the optimal strategy to diagnose the major burden of sleep disorders in general and agree that implementation of technological solutions may be accelerated by the coronavirus disease (COVID-19) pandemic. However, they are reluctant to discard an important test until alternative strategies have been rigorously tested and proven effective.