In which situation can unattended portable monitoring be used as an alternative to in-lab testing?

Unattended portable monitoring is often utilized as an alternative to in-lab testing when there is a high probability of obstructive sleep apnea (OSA), particularly in cases classified as moderate to severe. This method is suitable in situations where the likelihood of significant apnea events is high, as it allows for gathering necessary data while reducing costs and improving patient convenience. When patients are expected to have moderate to severe OSA, the data obtained from portable monitors can be quite effective for diagnosis without the additional complexities of comorbid conditions that might influence the results or treatment decisions.

While the other situations may involve some level of sleep apnea risk, they don't align perfectly with the criteria for utilizing portable monitoring effectively. For example, mild OSA or cases involving mild insomnia may not warrant the same level of urgency or diagnostic resolution that portable monitoring can provide compared to in-lab polysomnography, which is more comprehensive. Patient preference is significant, but it doesn't replace the clinical decision based on the patient’s clinical presentation and potential risk factors related to OSA.