Evaluation of a Single-Channel Portable Monitor for the Diagnosis of Obstructive Sleep Apnea

Abstract

Study Objective: To validate the ApneaLINK (AL) as an accurate tool for determining the presence of obstructive sleep apnea (OSA) in an at-risk sleep clinic population in a home test environment. Methods: Consecutive participants referred with the suspicion of OSA were evaluated in the home with the AL portable monitor (AL Home), followed by simultaneous data collection with diagnostic polysomnography (PSG) and AL in the sleep laboratory (AL Lab). Prevalence, sensitivity, specifi city, and ROC curves were calculated for PSG vs. AL Lab, PSG vs. AL Home, and AL Lab vs. AL Home test. Pearson correlations and Bland-Altman plots were constructed. Results: Fifty-three (55% female) participants completed the entire study. The mean age of the population was 45.1 ± 11.3 years, and body mass index was 35.9 ± 9.1 kg/m 2 . The prevalence of an apnea hypopnea index (AHI) ≥ 15 in the cohort was 35.9%. The results demonstrated a high sensitivity and specificity of the AL respiratory disturbance index (RDI-AL) compared with the AHI from the PSG. The AL Lab had the highest sensitivity and specificity at RDI-AL values ≥ 20 events/h (sensitivity 100%, specificity 92.5%). The AL Home was most sensitive and specific at an RDI-AL ≥ 20 events/h (sensitivity 76.9%, specificity 92.5%). The Pearson correlations for PSG vs. AL Lab and PSG vs. AL Home were ρ = 0.88 and ρ = 0.82, respectively. The BlandAltman Plots demonstrated good agreement between the methodologies. Conclusion: The AL home test is an accurate alternative to PSG in sleep clinic populations at risk for moderate and severe OSA. Trial Registration: clinicaltrials.gov ID: NCT00354614. Keywords: Obstructive sleep apnea, portable monitoring, diagnosis Citation: Oktay B; Rice TB; Atwood CW; Passero M; Gupta N; Givelber R; Drumheller OJ; Houck P; Gordon N; Strollo PJ. Evaluation of a single-channel portable monitor for the diagnosis of obstructive sleep apnea.

Relation of Obstructive Sleep Apnea to Coronary Artery Calcium in Non-Obese Versus Obese Men and Women Aged 45–75 Years

“…AHI was assessed using a single-channel portable monitor (ApneaLink, ResMed Corp) instead of polysomnography. However, the portable monitor that we used has been previously validated with acceptable performance to identify obstructive sleep apnea 5,29,30 . There was a low prevalence of severe sleep apnea (AHI ≥ 30: n = 25) in our sample.…”

“…Sleep apnea was assessed with a previously validated portable monitor that measures airflow and snoring via a nasal pressure signal (ApneaLink, ResMed Corp) 5 . An apnea was defined as a decrease in airflow of ≥ 80% from baseline for ≥ 10 seconds.…”

Beliefs and Attitudes Toward Obstructive Sleep Apnea Evaluation and Treatment Among Blacks

“…In this instance, devices such as the ApneaLINK Home Test have been shown to be an accurate and cost-effective alternative to the standard polysomnography. 47 …”

Feasibility of Portable Sleep Monitors to Detect Obstructive Sleep Apnea (OSA) in a Vulnerable Urban Population

“…16 Based on the signals recorded, the associated software generates a modified AHI value. With the understanding that portable sleep monitors underestimate the degree of apnea because they use total recording time rather than total sleep time in the calculation, we chose to use this technology.…”

“…14 Subjective screening questionnaires, such as the Epworth Sleepiness Scale (ESS) and the Berlin Questionnaire (BQ), although easy to use, have low sensitivity and specificity (ESS, 46% and 60%; BQ, 73% and 44%, respectively), rendering them an unacceptable alternatives for screening. 15 Portable sleep monitors have been validated with a higher sensitivity and specificity (76.9% and 92.5%, respectively) 16 and are gaining momentum after the implementation of a billing code in 2008. 17 Although PSG is the recommended followup for negative portable sleep monitor results in populations with a high-pretest probability to reduce the risk of false negatives, there is no standard for populations with lower risk and low access to PSG.…”