No abstract

STOP-BANG shows different discrimination power for AHI >5 and ≥30/h using RP. Five components in any combination have acceptable diagnostic S to identify patients with severe OSA. STOP-BANG performed best to identify AHI ≥30/h.

Study findings contribute to understand the role of oximetry in the diagnosis of OSA in obese patients. Our results were observed using full PSG and a simplified home method. The correlation between these indicators could improve our clinical interpretation of OSA severity among obese patients when abbreviated tests are used.

In hypertension (HT) patients, RP revealed a high prevalence of OSA associated with carotid artery disease, high PWV, and increased cardiovascular risk.

IntroductionObstructive sleep apnea syndrome (OSA) is diagnosed through polysomnography (PSG) or respiratory polygraphy (RP). Self-administered home-based RP using devices with data transmission could facilitate diagnosis in distant populations. The purpose of this work was to describe a telemedicine initiative using RP in four satellite outpatient care clinics (OCC) of Buenos Aires Hospital Británico Central (HBC).Materials and methodsOCC technicians were trained both in the use of RP. Raw signals were sent to HBC via intranet software for scoring and final report.ResultsDuring a 24-month 499 RP were performed in 499 patients: 303 men (60.7%) with the following characteristics (mean and standard deviation): valid time for manual analysis: 392.8 min (±100.1), AHI: 17.05 (±16.49 and percentile 25–75 [Pt]: 5–23) ev/hour, ODI (criterion 3%): 18.05 (±16.48 and Pt 25–75: 6–25) ev/hour, and time below 90% (T<90): 17.9% (±23.4 and Pt 25–75: 1–23). The distribution of diagnoses (absolute value and percentage) was: normal (66/13%), snoring (70/14%), mild (167/33.5%), moderate (110/22%), and severe (86/17.2%). Continuous positive airway pressure (CPAP) was indicated for 191 patients (38.6%). Twenty recordings (4%) were considered invalid and the RP had to be repeated.PSG at HBC was indicated in 60 (12.1%) cases (mild OSA or normal AHI with high ESS or cardiovascular disease).ConclusionsPhysicians were able to diagnosis OSA by doing portable respiratory polygraphy at distance. The remote diagnosis strategy presented short delays, safe data transmission, and low rate of missing data.

ObjectiveTo establish the prevalence of positional (PP) OSA patients using self-administered home-based respiratory polygraphy (RP).Materials and Methods52 month retrospective study based on RP records.Results200 PR records: 70.5% men 29.5% women. 76% were diagnosed with OSA and 54.6% with PP OSA. There were no significant differences in Epworth Sleepiness Scale, apnea hypopnea index and oxygen desaturation index. PP OSA patients were younger, had a lower BMI (30.3±0.9 vs. 35.3±1.2) (p<0.0001), and the time they spent with oxygen saturation <90% (T<90) was lower (8.8 vs. 28.7±6.7, p=0.0038). The PP OSA group spent 43% of total recording time in the supine position.ConclusionsThe prevalence of PP OSA patients studied with RP is similar to the one described by sleep laboratories. They have lower BMI, present mostly mild OSA with less desaturation, and are less likely to receive CPAP therapy.

(Rev Med Chile 2014; 142: 382-385)

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