Home Diagnosis of Sleep Apnea: A Systematic Review of the Literature

Flemons, W. Ward; Littner, Michael R.; Rowley, James A.; Gay, Peter C.; Anderson, William; Hudgel, David W.; McEvoy, R. Doug; Loube, Daniel I.

doi:10.1378/chest.124.4.1543

Cited by 501 publications

(244 citation statements)

References 79 publications

(135 reference statements)

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“…The performance of SM in detecting and screening SDB in this HF cohort was comparable to other forms of portable/home contact screening devices 14, 15, 16, 17, 18, 19. However, most of these studies only included patients without HF.…”

Section: Discussionmentioning

confidence: 75%

“…Exclusion of data from five patients was because of poor signal quality. The failure rate for SM was therefore 6.25%, which is comparable to contact devices used either at home, or in‐hospital 16. Refinement of the hardware and algorithm could lower the failure rate.…”

Section: Discussionmentioning

confidence: 84%

“…PMs are usually used as an initial diagnostic or screening tool and in selected patients, if the test results are positive, can be used to recommend treatment, while ruling out additional testing if results were negative 16. PMs can be used on an unattended basis, and several studies have reported a high diagnostic accuracy of up to 90% in detecting SDB 17, 18, 19, 20, 21.…”

Section: Introductionmentioning

confidence: 99%

“…PMs can be used on an unattended basis, and several studies have reported a high diagnostic accuracy of up to 90% in detecting SDB 17, 18, 19, 20, 21. High study failure rates because of their complex unattended design can, however, result in the need for repeated studies 16. Overnight pulse oximetry and heart rate variability are some of the methods employed to screen for SDB with varying degrees of accuracy and usefulness reported 20, 21.…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of a novel non‐contact monitor of nocturnal respiration for identifying sleep‐disordered breathing in patients with heart failure

et al. 2016

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AimsAt least 50% of patients with heart failure (HF) may have sleep‐disordered breathing (SDB). Overnight in‐hospital polysomnography (PSG) is considered the gold standard for diagnosis, but a lack of access to such testing contributes to under‐diagnosis of SDB. Therefore, there is a need for simple and reliable validated methods to aid diagnosis in patients with HF. The aim of this study was to investigate the accuracy of a non‐contact type IV screening device, SleepMinderTM (SM), compared with in‐hospital PSG for detecting SDB in patients with HF.Methods and resultsThe study included 75 adult patients with systolic HF and suspected SDB who underwent simultaneous PSG and SM recordings. An algorithm was developed from the SM signals, using digital signal processing and pattern recognition techniques to calculate the SM apnoea‐hypopnoea index (AHI). This was then compared with expert‐scored PSGAHI. The SM algorithm had 70% sensitivity and 89% specificity for identifying patients with clinically significant SDB (AHI ≥ 15/h). At this threshold, it had a positive likelihood ratio of 6.3 and a negative likelihood ratio of 0.16. The overall accuracy of the SMAHI algorithm was 85.8% as shown by the area under a receiver operator characteristic curve. The mean AHI with SM was 3.8/h (95% confidence interval 0.5–7.1) lower than that with PSG.ConclusionsThe accuracy of the non‐contact type IV screening device SM is good for clinically significant SDB in patients with systolic HF and could be considered as a simple first step in the diagnostic pathway.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development and validation of a novel non‐contact monitor of nocturnal respiration for identifying sleep‐disordered breathing in patients with heart failure

et al. 2016

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“…The study by Wiltshire et al (2001) showed that low sampling rates provide SaO 2 recordings with a low number of artefacts. However, low sampling frequencies potentially reduce the sensitivity and increase the specificity of a diagnostic test (Flemons et al 2003). An additional limitation should be taken into account, related to the lack of repeated sleep studies in successive nights.…”

Section: Discussionmentioning

confidence: 99%

Nonlinear measure of synchrony between blood oxygen saturation and heart rate from nocturnal pulse oximetry in obstructive sleep apnoea syndrome

Álvarez¹,

Hornero²,

Abásolo³

et al. 2009

Physiol. Meas.

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This study focuses on the analysis of the relationship between changes in blood oxygen saturation (SaO 2 ) and heart rate (HR) recordings from nocturnal pulse oximetry (NPO) in patients suspected of suffering from obstructive sleep apnoea (OSA) syndrome. Two different analyses were developed: a classical frequency analysis based on the magnitude squared coherence (MSC) and a nonlinear analysis by means of a recently developed measure of synchrony, the cross approximate entropy (cross-ApEn). A data set of 187 subjects was studied. We found significantly higher correlation and synchrony between oximetry signals from OSA Positive patients compared with OSA Negative subjects. We assessed the diagnostic ability to detect OSA syndrome of both the classical and nonlinear approaches by means of receiver operating characteristic (ROC) analyses with ten-fold cross-validation. The nonlinear measure of synchrony significantly improved the results obtained with classical MSC: 69.2% sensitivity, 90.9% specificity and 78.1% accuracy were reached with MSC, whereas 83.7% sensitivity, 84.3% specificity and 84.0% accuracy were obtained with cross-ApEn. Our results suggest that the use of nonlinear measures of synchrony could provide essential information from oximetry signals, which cannot be obtained with classical spectral analysis.

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Soluble Interleukin 6 Receptor

et al. 2006

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Morning sIL-6R levels demonstrated stronger associations with moderate to severe SRBD than morning IL-6 levels. Associations with SRBD and morning sIL-6R levels persisted even after adjustment for waist circumference, cardiovascular disease, and evening sIL-6R levels, suggesting the potential utility of sIL-6R as a marker for measuring overnight SRBD stresses. Further investigation of this biomarker may provide insight into SRBD-related inflammation.

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Home Diagnosis of Sleep Apnea: A Systematic Review of the Literature

Cited by 501 publications

References 79 publications

Development and validation of a novel non‐contact monitor of nocturnal respiration for identifying sleep‐disordered breathing in patients with heart failure

Development and validation of a novel non‐contact monitor of nocturnal respiration for identifying sleep‐disordered breathing in patients with heart failure

Nonlinear measure of synchrony between blood oxygen saturation and heart rate from nocturnal pulse oximetry in obstructive sleep apnoea syndrome

Soluble Interleukin 6 Receptor

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