Domino software

Prior the investigation, the PSG hardware was presented to the subjects. That included a head box dummy that a contact person or the participant himself could wear for some days, this way adapting to it. All PSGs were realized as one-night measurements. For polysomnography, we used the following electrodes and sensors: EEG: F3, F4, C3, C4, CZ (as reference), O1, O2, A1, A2, and FpZ (as ground), EOG one site, EMG: chin, tibialis anterior muscle right (TAR) and left (TAL), ECG, thoracic and abdominal belt, flow, and position sensor. The system used was the Somnoscreen plus^© (SOMNOmedics GmbH, Randersacker, Germany). Data were collected and transferred via Bluetooth, with no electric wires between head box (located at participants chest), camera, or recording laptop being necessary. That gave participant the opportunity to move around without restrictions. Analyses were conducted by educated and experienced staff. Standard values were computed via the Domino^© software (SOMNOmedics GmbH, Randersacker, Germany).

As previously described, the sleep evaluation was performed during in-hospital diagnostics with ICP measurements [4 (link)]. Polysomnography (PSG) is a standard criterion method and was performed according to the American Academy of Sleep Medicine (AASM) standards [electroencephalogram (EEG), electrooculography (EOG), submental- and anterior tibialis electromyography (EMG), electrocardiography (ECG), airflow, respiratory inductance plethysmography (RIP), snoring, and oxyhemoglobin saturation (SaO₂)], and was recorded with Domino™ software (SOMNOmedics GmbH, Germany). Recordings were scored manually according to the AASM by an independent trained professional supervised by an experienced expert in neurophysiology, both blinded to the diagnosis of the patients. Sleep-disordered breathing is reported as the apnea–hypopnea index (AHI) following the AASM 2012 standard. In addition, two patients with IIH and two with pediatric-onset were monitored with end-tidal CO₂ (LoFlo, Respironics, Inc.) according to the manufacturer's protocol.

The polysomnographic analysis was performed using the SOMNOtouchTM® NIBP device (SOMNOmedics Italia, Bellusco, Italy) and a complete cardiorespiratory night monitoring was carried out for at least 8 h. During polysomnography peripheral, blood oxygen saturation, respiratory flow in the upper airway, respiratory movements of the chest and abdomen, snoring phases, the position of the patient, blood pressure and electrocardiogram with acquisition of peripheral signals were recorded. The recorded layout and thus the criterion for assigning hypopneas scoring was automatically analyzed by the DOMINO software®, validated by SOMNOmedics, and subsequently it was manually validated by an expert operator according to the most recent American Academy of Sleep Medicine (AASM) criteria [37 (link)]. The anthropometric data included age, height and weight. The polysomnographic data encompassed Apnea Hypopnea Index (AHI), minimum percentage oxyhaemoglobin saturation (mSaO2%), mean percentage oxyhaemoglobin saturation (meanSaO2%), percentage of time with oxyhaemoglobin saturation percentage less than 90 (TS < 90%) and number of desaturations with oxyhaemoglobin saturation < 90% (nSaO2 < 90%).