0559 Predictive Parameters of Veterans with False Negative Home Sleep Apnea Test in Diagnosis of Obstructive Sleep Apnea

Abstract Introduction Obstructive sleep apnea (OSA) is prevalent among United States Veterans. The STOP-BANG questionnaire and Home Sleep Apnea Testing (HSAT) provide a cost-effective alternative to polysomnography (PSG). However, HSAT's diagnostic accuracy is not always precise. Our hypothesis posits a higher false negative (FN) rate in veterans with specific demographics or comorbidities, even with a STOP-BANG score of 3 or more. Our study explores variations in HSAT diagnostic accuracy across demographics and predictive parameters for FN HSAT in identifying OSA patients. Methods This retrospective chart review includes Veterans referred to SLVHCS Sleep Center for OSA evaluation (01/01/2023 to 12/01/2023) with a STOP-BANG score of 3 or more. HSAT with WatchPAT® was performed, followed by confirmatory PSG post-negative WatchPAT® analysis. FN rates and predictive parameters were compared between FN and true negative (TN) using paired t-testing and chi-square testing. Results A total of 107 negative HSAT patients (68.22% male, 31.78% female) with an average age of 43.36 ± 11.9 were included in the study. Among patients with negative HSATs, males had a higher FN rate than females (73% vs. 44%, p=0.0028). Further analyses showed no significant differences in age, BMI, PSG sleep time, STOP-BANG score, or psychiatric comorbidity between false and true negatives. Interestingly, a trend was noticed in African Americans, who had more FN tests than Caucasians (69.8% vs. 59.2%, p=0.090). Conclusion Our findings suggest a higher likelihood of FN results in negative HSATs among male compared to female Veterans. Additionally, there may be an association of higher FN tests in the African American race. Further analyses with a larger sample size and inclusion of true positive tests are needed for a conclusive assessment of HSAT's diagnostic capability in the specified categories. Support (if any)