Comparison of a cardiorespiratory deviceversuspolysomnography for diagnosis of sleep apnoea

Abstract

Comparison of a cardiorespiratory device versus polysomnography for diagnosis of sleep apnoea. J.M. Calleja, S. Esnaola, R. Rubio, J. Durán. #ERS Journals Ltd 2002. ABSTRACT: This study assessed the accuracy of a cardiorespiratory monitoring device versus polysomnography for the diagnosis of suspected sleep apnoea/hypoponea syndrome (SAS).A total of 86 patients (89% male, mean age 52 yrs) that had been referred to a sleep laboratory with a clinical diagnosis of SAS underwent cardiorespiratory polygraphy in an unattended mode using an ambulatory device (MERLIN). Analysis was carried out both automatically and manually. Conventional overnight full-channel polysomnography was performed simultaneously.Valid polygraphical recordings were obtained from 79 patients. The mean ¡ SD apnoea/hypopnoea index (AHI) was 34.4 ¡ 29.2. The results obtained with manual scoring were superior to automatic scoring for all AHI thresholds. For an AHI of o5, which is diagnostic SAS, the optimum cut-off value for the manual respiratory event index was 6.7 and the cardiorespiratory monitoring device had 97.1% sensitivity and 90.9% specificity. Correct classification according to the different cut-off points obtained via polysomnography and the corresponding cut-off points in the MERLIN manual index were confirmed in 90-96% of patients.The MERLIN device is a useful diagnostic approach for the initial assessment of adult patients with clinical suspicion of sleep apnoea/hypopnoea syndrome. Manual scoring is clearly better than automatic scoring in terms of agreement with the apnoea/ hypopnoea index and to discern patients with sleep apnoea/hypopnoea syndrome.

Misclassification of OSA Severity With Automated Scoring of Home Sleep Recordings

“…Similar to the current fi ndings, previously examined automated algorithms tend to underestimate the AHI compared with manual scoring. 11,12,14 Underestimation of the AHI could lead to misclassifi cation of patients with mild OSA as being normal and thus limit the utility of automated scoring algorithms in screening for OSA. In contrast to the AHI, higher concordance between manual and automated scoring was observed with the ODI.…”

“…OSA severity can also aff ect automated scoring accuracy, which improves with increasing disease severity. 10 Not surprisingly, visual (manual) scoring of portable monitoring data is superior to automated scoring and improves the reliability of automated scoring for both type 3 [11][12][13][14][15][16] and type 4 [17][18][19][20][21][22][23] portable monitors when AHI is used to identify and classify OSA. Similar to the current fi ndings, previously examined automated algorithms tend to underestimate the AHI compared with manual scoring.…”

Effects of Nocturnal Oxygen Therapy on Outcome Measures in Patients With Chronic Heart Failure and Cheyne-Stokes Respiration

“…The oximeter signal quality of the cardiorespiratory monitoring device was proved to be valid in comparison with PSG. 26 Home respiratory polygraphy has also been confirmed as a useful alternative to overnight PSG for diagnosis of SDB in heart failure. 27 Standard definitions were used for OSA and CSA on the basis of the presence or absence of rib cage and abdominal excursions with an absence of airflow.…”

Impact of obstructive sleep apnoea on diastolic function

“…However, different studies investigating the ability of polygraphy to detect sleep-disordered breathing showed a high diagnostic accuracy of the portable recording devices [42][43][44]. It is unlikely that the additional information on sleep stages given by polysomnography would profoundly modify the results.…”