ISSN 2667-7466 | E-ISSN 2667-7474
Original Article
Comparison of Manual and Automated Scoring Techniques in Polysomnography
1 Department of Otorhinolaryngologic Diseases Faculty of Medicine, Akdeniz University, Antalya, Turkey  
Turk Arch Otorhinolaryngol 2014; 52: 17-21
DOI: 10.5152/tao.2014.422
Key Words: Polysomnography, manual scoring, automated scoring, OSA

Objective: Polysomnography (PSG) scoring can be performed manually or with an automated programme. The purpose of this study is to compare two different scoring techniques in PSG.


Methods: The sleep recordings of 120 patients with obstructive sleep apnoea (OSA) suspicion who underwent PSG at ear nose and throat clinic of Akdeniz University Hospital between January and June 2013 were retrospectively analysed. Patients were divided into 4 groups according to the apnoea-hypopnea index (AHI): AHI<5 (normal), AHI 5-15 (mild OSA), AHI 15-30 (moderate OSA) and AHI>30 (severe OSA). There were 30 patients in each group. Manually scored recordings were reanalysed with an automated programme and the results, including sleep stages and respiratory events, were compared.


Results: A total of 86.400 epochs of 120 patients were reanalysed. In all patients, the total sleep time and sleep efficiency were decreased with automated scoring by 29 min and 6%, respectively (p=0.001). The percentage of stage I sleep was higher and REM was lower, respectively (p=0.001 for both parameters). In automated scoring, the number of cases of obstructive and central apnoea were lower (p=0.001), and the number of cases of hypopnoea, mean apnoea duration and hypopnoea duration were higher (p=0.001, p=0.001 and p=0.039, respectively). There were no statistically significant differences in the total AHI and REM AHI between two scoring techniques (p=0.053 and p=0.319, respectively). However, NREM AHI was significantly higher in the automated scoring (p=0.002). Sensitivity, specificity, positive predictive value and negative predictive value of automated scoring were 98.88%, 93.33%, 97.80% and 95.55%, respectively.


Conclusion: Automated scoring is not sufficiently accurate for many sleep parameters. Inconsistency between the two techniques is apparent, especially in patients with mild to moderate forms of OSA.

Key Words
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