Effectiveness of Home Single-Channel Nasal Pressure for Sleep Apnea Diagnosis

Jf, Masa; Durán-Cantolla, Joaquín; Capote, Francisco; Cabello, Marta; Abad, Jorge; García‐Río, Francisco; Ferrer, Antoni; Mayos, Merçé; González-Mangado, Nicolás; Peña, Marcos de la; Aizpuru, Felipe; Barbé, Ferrán; Montserrat, Josep M.; Ld, Larrateguy; Castro, Javier de; García-Ledesma, Estefanía; Utrabo, Isabel; Corral, Jaime; Martínez-Null, Cristina; Egea, Carlos; Cancelo, Laura; García-Díaz, Emilio; Carmona-Bernal, Carmen; Sánchez‐Armengol, Ángeles; Am, Fortuna; Rm, Miralda; Troncoso, María F.; Monica, Giordano; Martínez-Martínez, Marián; Cantalejo, Olga; Piérola, Javier; Vigil, Laura; Embid, Cristina; M, Del Mar Centelles; Tr, Prieto; Rojo, Blas; Lores, Vanesa

doi:10.5665/sleep.4248

Cited by 42 publications

(20 citation statements)

References 30 publications

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“…Overall, we had a relatively low participation rate (70% of all patients recruited) of patients who spent one night with the ApneaLink TM at home and one night in the sleep laboratory for PSG examination. However, another study reported 79% of valid ApneaLink TM autoscore recordings [ 37 ], which is comparable with our study.…”

Section: Discussionsupporting

confidence: 92%

“…We also recommend that issues such as marital problems, loss of job, or experiencing a traffic accident are not disregarded, as these problems may occur simultaneously and might be complications of an OSAS [ 50 ]. The use of the automatic ApneaLink TM device requires development of integrated networks between nonspecialist and specialist practitioners to allow achieving an expert system to be managed by nonexperts [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies with comparable screening devices (not only ApneaLink TM ) stated that manual revision is useful [ 37 , 43 ], whereas other studies reported that revised results did not differ significantly from autoscores [ 44 ]. Our manual evaluator worked without knowing PSG results or the patients' group assignment.…”

Section: Discussionmentioning

confidence: 99%

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Screening for obstructive sleep apnea among hospital outpatients

et al. 2018

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BackgroundObstructive sleep apnea syndrome (OSAS) is common in adults. People with OSAS have a higher risk of experiencing traffic accidents and occupational injuries (OIs). We aimed to clarify the diagnostic performance of a three-channel screening device (ApneaLinkTM) compared with the gold standard of full-night attended polysomnography (PSG) among hospital outpatients not referred for sleep-related symptoms. Furthermore, we aimed to determine whether manual revision of the ApneaLinkTM autoscore enhanced diagnostic performance.MethodsWe investigated 68 patients with OI and 44 without OI recruited from the University Hospital Basel emergency room, using a cross-sectional study design. Participating patients spent one night at home with ApneaLinkTM and within 2 weeks slept for one night at the sleep laboratory. We reanalyzed all ApneaLinkTM data after manual revision.ResultsWe identified significant correlations between the ApneaLinkTM apnea-hypopnea index (AHI) autoscore and the AHI derived by PSG (r = 0.525; p <0.001) and between the ApneaLinkTM oxygen desaturation index (ODI) autoscore and that derived by PSG (r = 0.722; p <0.001). The ApneaLinkTM autoscore showed a sensitivity and specificity of 82% when comparing AHI ≥5 with the cutoff for AHI and/or ODI ≥15 from PSG. In Bland Altman plots the mean difference between ApneaLinkTM AHI autoscore and PSG was 2.75 with SD ± 8.80 (β = 0.034), and between ApneaLinkTM AHI revised score and PSG -1.50 with SD ± 9.28 (β = 0.060).ConclusionsThe ApneaLinkTM autoscore demonstrated good sensitivity and specificity compared with the gold standard (full-night attended PSG). However, Bland Altman plots revealed substantial fluctuations between PSG and ApneaLinkTM AHI autoscore respectively manually revised score. This spread for the AHI from a clinical perspective is large, and therefore the results have to be interpreted with caution. Furthermore, our findings suggest that there is no clinical benefit in manually revising the ApneaLinkTM autoscore.

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Section: Discussionsupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

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Screening for obstructive sleep apnea among hospital outpatients

et al. 2018

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“… 10 21 Our results show that RDI MAN agreed slightly better than RDI RAW with the laboratory AHI but, again, the differences were small compared with the confidence limits. Our Bland-Altman plots did not show the large differences between the manually scored and the computer-scored RDI for the ApneaLink Plus that were reported in a recent paper by Aurora et al 22 Unlike the 2014 paper from Masa et al , 23 we did not see much difference between the receiver–operator characteristic curves for mild, moderate and severe sleep apnoea when comparing the laboratory polysomnography with home testing performed on a different night. However, they had studied a much larger group of participants than we did and they used the ApneaLink, which records only nasal airflow, rather than the four-channel ApneaLink Plus.…”

Section: Discussioncontrasting

confidence: 84%

Type III home sleep testing versus pulse oximetry: is the respiratory disturbance index better than the oxygen desaturation index to predict the apnoea-hypopnoea index measured during laboratory polysomnography?

et al. 2015

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ObjectivesIn its guidelines on the use of portable monitors to diagnose obstructive sleep apnoea, the American Academy of Sleep Medicine endorses home polygraphy with type III devices recording at a minimum airflow the respiratory effort and pulse oximetry, but advises against simple pulse oximetry. However, oximetry is widely available and simple to use in the home. This study was designed to compare the ability of the oxygen desaturation index (ODI) based on oximetry alone with a stand-alone pulse oximeter (SPO) and from the oximetry channel of the ApneaLink Plus (ALP), with the respiratory disturbance index (RDI) based on four channels from the ALP to predict the apnoea–hypopnoea index (AHI) from laboratory polysomnography.DesignCross-sectional diagnostic accuracy study.SettingSleep medicine practice of a multispecialty clinic.ParticipantsPatients referred for laboratory polysomnography with suspected sleep apnoea. We enrolled 135 participants with 123 attempting the home sleep testing and 73 having at least 4 hours of satisfactory data from SPO and ALP.InterventionsParticipants had home testing performed simultaneously with both a SPO and an ALP. The 2 oximeter probes were worn on different fingers of the same hand. The ODI for the SPO was calculated using Profox software (ODISOX). For the ALP, RDI and ODI were calculated using both technician scoring (RDIMAN and ODIMAN) and the ALP computer scoring (RDIRAW and ODIRAW).ResultsThe receiver–operator characteristic areas under the curve for AHI ≥5 were RDIMAN 0.88 (95% confidence limits 0.81–0.96), RDIRAW 0.86 (0.76–0.94), ODIMAN 0.86 (0.77–0.95), ODIRAW 0.84 (0.75–0.93) and ODISOX 0.83 (0.73–0.93).ConclusionsWe conclude that the RDI and the ODI, measured at home on the same night, give similar predictions of the laboratory AHI, measured on a different night. The differences between the two methods are small compared with the reported night-to-night variation of the AHI.

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“…Portable sleep monitors (PMs), which can also be used in the home environment, are being used more frequently because of their simplicity, costs, and effectiveness. [8,9] In this study, we aimed to investigate the diagnostic efficacy of PMs in Turkish population by comparing them with the parameters of PSG, the apnea-hypopnea index (AHI), and the oxygen desaturation index (ODI) in the laboratory.…”

Section: Introductionmentioning

confidence: 99%

Is it possible to use portable monitors which are cheaper and simpler method in Obstructive Sleep Apnea Diagnosis?

Saraç

2018

South Clin Ist Euras

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Objective: Obstructive sleep apnea (OSA) affects mortality and morbidity due to persistent hypoxemia attacks during the night. The use of portable sleep monitors (PMs) has been investigated in recent years because the use of polysomnography (PSG) in the OSA diagnosing is a rare and expensive method. In our study, we aimed to investigate the compliance of Turkish population to PMs and PSG.Methods: Demographic records of 62 patients referred with OSA symptoms were collected from the database. An ear, nose, and throat (ENT) physician was examination was pweformed for all patients. Afterwards, sleep records were taken with PM, followed by PSG.Results: There was no difference between the PM and PSG parameters in terms of the apnea-hypopnea index and the oxygen desaturation index. The sensitivity of the PMs was 89%, and the specificity was 100%. Conclusion:This study showed that the PM and PSG parameters were compatible with each other. We concluded that portable monitors that are cheaper, simpler, and capable of shooting at home can be used in the diagnosis of OSA, where obesity and OSA are very common.

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Effectiveness of Home Single-Channel Nasal Pressure for Sleep Apnea Diagnosis

Abstract: Clinicaltrials.gov identifier: NCT01347398.

Cited by 42 publications

References 30 publications

Screening for obstructive sleep apnea among hospital outpatients

Screening for obstructive sleep apnea among hospital outpatients

Type III home sleep testing versus pulse oximetry: is the respiratory disturbance index better than the oxygen desaturation index to predict the apnoea-hypopnoea index measured during laboratory polysomnography?

Is it possible to use portable monitors which are cheaper and simpler method in Obstructive Sleep Apnea Diagnosis?

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