Automated vs Manual Polysomnography Scoring in Adults With Obstructive Sleep Apnea

Study Procedures

• Pre-PSG Assessment: Demographic data, anthropometric measurements (weight, height, Body mass index (BMI), neck circumference), vital signs, comorbidities, and the STOP-BANG questionnaire are recorded.
• Overnight PSG: Conducted in a sound-attenuated, temperaturecontrolled, well-prepared sleep lab using either SOMNOscreen plus (SOMNOmedics GmbH) or Alice® 6 Sleepware (Philips Respironics, PA,

USA). Both systems acquire this channels montage:

• EEG (six channels: F3, F4, C3, C4, O1, O2 referenced to ipsilateral mastoids)

• EOG (two channels: left and right outer canthus)

• Chin EMG (three channels) and anterior tibialis EMG (two channels, bilateral)

• Airflow (oronasal thermistor + nasal pressure transducer cannula)

• ECG (2 leads)

• Body position sensor

• Snoring microphone

Respiratory inductive plethysmography (RIP) belts for thoracic and abdominal effort (two channels)

• Pulse oximetry (SpO₂, one channel) via finger probe

Inclusion criteria

• Age > 18 years.
• Clinical suspicion of OSA based on history, physical examination, and a positive screening questionnaire (e.g., STOP-BANG ≥ 3).
• Ability to provide written informed consent.

Exclusion criteria

• Age ≤ 18 years.
• Inability to give informed consent (e.g., severe cognitive impairment, language barrier).
• Contraindications to PSG (e.g., severe skin conditions preventing electrode placement).
• Current use of therapies that could alter sleep architecture (e.g., highdose benzodiazepines, opioids) unless a wash-out period is observed.