The Debated Role of Sleep Studies in Patients Under Established Home Mechanical Ventilation
The Debated Role of Sleep Studies in Patients Under Established Home Mechanical Ventilation
Patients suffering chronic hypercapnic respiratory insufficiency (e.g. in chronic obstructive
 pulmonary disease, obesity hypoventilation syndrome) benefit from home mechanical
 ventilation. These patients are complex; and the ventilator´s parameters should be set-up
 according to the underlying disease and particular patient's characteristics. The
 non-invasive ventilation therapy is mostly titrated while the patient is awake, hence
 Problems, such as Patient-Ventilator asynchrony, arising while sleeping on the ventilator
 therapy would remain undetected.

 Sleep studies, such as polysomnography or polygraphy and transcutaneous carbon dioxide
 monitoring could be valuable tools to fine-tune the ventilator's settings. This could foster
 the ventilator´s effectivity and patient satisfaction, thus therapy's adherence. Nevertheless
 the sleep studies are expensive, time-consuming and not widely available.

 The aim of this study is to learn the findings of sleep studies when they are performed on
 stable patients on home mechanical ventilation as part of their routine check-ups. In this
 context, it will be assessed whether the sleep studies' findings lead to a change
 (adjustment) of the ventilator´s therapy. Moreover, this study aims to investigate whether
 the absence of sleep studies would result in missing important events that require an
 adjustment of therapy. The results of this study could provide information that lead to a
 more standardized protocol of follow-up checks of patients on home mechanical ventilation in
 a cost-effective manner.
Inclusion Criteria:

 -  Patients with chronic hypercapnic respiratory failure secondary to one or more
 identified condition(s) (chronic obstructive pulmonary disease, obesity
 hypoventilation syndrome, neuromuscular diseases, restrictive lung diseases)

 -  Home mechanical ventilation for ≥ 6 months

 -  Stable condition for ≥ 1 month

 Exclusion Criteria:

 -  Previous adjustment of the noninvasive ventilation therapy under sleep studies in the
 last 6 months

 -  Current respiratory exacerbation

 -  Any current comorbidity decompensation

 -  Any medical or psychological condition impairing the patient's ability to provide
 informed consent

 -  Missing signed informed consent

 -  Total sleep time during polysomnography <180 min