Diagnosis of Obstructive Sleep Apnea Syndrome and Its Outcomes With Home Portable Monitoring

Oliveira, Ana Claudia Tonelli de; Martinez, Dênis; Vasconcelos, Luiz Felipe T.; Gonçalves, Sandro Cadaval; Lenz, Maria do Carmo Sfreddo; Fuchs, Sandra Costa; Gus, Miguel; Abreu-Silva, Erlon Oliveira de; Moreira, Leila Beltrami; Fuchs, Flávio Danni

doi:10.1378/chest.08-1859

Cited by 113 publications

(79 citation statements)

References 35 publications

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“…[46][47][48]52,55,81,88,89,98,104 In addition, 7 of 14 inlaboratory studies showed a decline in sensitivity and an increase in specificity, and 2 studies showed an increase in area under the ROC curve. 47,48,51,52,58,[61][62][63][65][66][67][69][70][71] We found no significant difference in baseline characteristics between the 2 groups of patients in all 8 studies that reported disease management after the diagnosis by either test.…”

Section: Diagnostic Accuracy Of Sleep Testsmentioning

confidence: 99%

Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis

Shayeb

Topfer

Stafinski

et al. 2013

CMAJ

187

104

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Section: Diagnostic Accuracy Of Sleep Testsmentioning

confidence: 99%

Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis

Shayeb

Topfer

Stafinski

et al. 2013

CMAJ

187

104

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“…35,53,54,81,86,88,93,96,116 The required signals and minimum durations included nasal pressure flow and oximetry for at least 3 hours 88,93,116 or 4 hours 53,81,86,96 and single-channel nasal airflow recording for a minimum of 3 hours 35 or only 2 hours. 54 The diagnostic accuracy of the cardiorespiratory devices compared against PSG for the detection of OSA at different AHI cutoff points was relatively high.…”

mentioning

confidence: 99%

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Kapur

Auckley

Chowdhuri

et al. 2017

Journal of Clinical Sleep Medicine

2,037

1,498

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Introduction: This guideline establishes clinical practice recommendations for the diagnosis of obstructive sleep apnea (OSA) in adults and is intended for use in conjunction with other American Academy of Sleep Medicine (AASM) guidelines on the evaluation and treatment of sleep-disordered breathing in adults. Methods: The AASM commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use. In addition, the task force adopted foundational recommendations from prior guidelines as "good practice statements", that establish the basis for appropriate and effective diagnosis of OSA. The AASM Board of Directors approved the final recommendations. Recommendations:The following recommendations are intended as a guide for clinicians diagnosing OSA in adults. Under GRADE, a STRONG recommendation is one that clinicians should follow under most circumstances. A WEAK recommendation reflects a lower degree of certainty regarding the outcome and appropriateness of the patient-care strategy for all patients. The ultimate judgment regarding propriety of any specific care must be made by the clinician in light of the individual circumstances presented by the patient, available diagnostic tools, accessible treatment options, and resources. Good Practice Statements:Diagnostic testing for OSA should be performed in conjunction with a comprehensive sleep evaluation and adequate follow-up. Polysomnography is the standard diagnostic test for the diagnosis of OSA in adult patients in whom there is a concern for OSA based on a comprehensive sleep evaluation. Recommendations:1. We recommend that clinical tools, questionnaires and prediction algorithms not be used to diagnose OSA in adults, in the absence of polysomnography or home sleep apnea testing. (STRONG) 2. We recommend that polysomnography, or home sleep apnea testing with a technically adequate device, be used for the diagnosis of OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA. (STRONG) 3. We recommend that if a single home sleep apnea test is negative, inconclusive, or technically inadequate, polysomnography be performed for the diagnosis of OSA. (STRONG) 4. We recommend that polysomnography, rather than home sleep apnea testing, be used for the diagnosis of OSA in patients with significant cardiorespiratory disease, potential respiratory muscle weakness due to neuromuscular condition, awake hypoventilation or suspicion of sleep related hypoventilation, chronic opioid medication use, history of stroke or severe insomnia. (STRONG) 5. We suggest that, if clinically appropriate, a split-night diagnostic protocol, rather than a full-night diagnostic protoc...

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“…1,[33][34][35] For the GoToSleep study, full unattended polysomnography is conducted using the portable Safiro device (Compumedics) providing data on: electroencephalogram (EEG), electrooculogram, chin electromyogram, thoracic and abdominal displacement, airflow, finger pulse oximeter, electrocardiogram, body position, leg movement, and audio recording of participant's snoring. Trained research staff members travel to the patient to apply the sleep monitor in the location that is most convenient for the patient (usually the patient's home).…”

Section: Intervention Patientsmentioning

confidence: 99%

Diagnosis and Treatment of Sleep Apnea in Patients' Homes: The Rationale and Methods of the “GoToSleep” Randomized-Controlled Trial

Bravata

Ferguson

Miech³

et al. 2012

Journal of Clinical Sleep Medicine

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Diagnosis of Obstructive Sleep Apnea Syndrome and Its Outcomes With Home Portable Monitoring

Cited by 113 publications

References 35 publications

Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis

Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis

Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Diagnosis and Treatment of Sleep Apnea in Patients' Homes: The Rationale and Methods of the “GoToSleep” Randomized-Controlled Trial

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