Nocturnal oximetry in the diagnosis of obstructive sleep apnea syndrome in potentially hypoxic patients due to neuromuscular diseases

Filho, Júlio Cezar Rodrigues; Neves, Denise Duprat; Moreira, Gustavo Antônio; Viana, Alonço; Araújo-Melo, Maria Helena de

doi:10.1016/j.sleep.2021.05.009

Cited by 2 publications

(7 citation statements)

References 29 publications

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“…For the identification of a patient of AHI ≥ 15/h, the optimal cutoff of REI was 12.1/h, while that of ODI 3 was 8.1/h, which would balance the sensitivity and specificity for moderate to severe OSA. Our results are consistent with the findings of Westenberg et al and Rodrigues Filho et al ( 12 , 22 ).…”

Section: Discussionsupporting

confidence: 94%

“…It indicated that ODI 3 also had a screening value for OSA in postpolio patients. For potentially hypoxic patients due to NMD, Rodrigues Filho et al used different degrees of baseline SpO 2 drop (3, 4, and 5%) and created a time criterion for the duration of desaturation, and then they found ODI 3/2 (ODI 3 with the duration of 2 s) has the best sensitivity and specificity ( 22 ). Unfortunately, the software of Pulsox-300i could not provide such variables, so we could not repeat their findings.…”

Section: Discussionmentioning

confidence: 99%

“…The AUC of ODI 3 ≥ 15/h was 98% which is higher than that of REI. ODI 3 was proven to be a diagnostic tool for OSA, even in patients with NMD and potentially hypoxic diseases ( 22 ). However, due to low sensitivity, underestimation of AHI, and inability to distinguish different SDB types, REI from type 3 PM and ODI 3 from type 4 PM alone are not adequate measures to diagnose SDB in postpolio subjects.…”

Section: Discussionmentioning

confidence: 99%

“…Due to inconvenient movement and limited financial capacity, type 3 PM is a more accessible way to diagnose OSA for polio survivors. Type 4 PM has the advantage of easy set-up and a high success rate, also leading it to be an alternative way to screen OSA for polio survivors ( 19 , 22 ). The results of our current study also provide supportive evidence for the use of type 3 and type 4 PMs.…”

Section: Discussionmentioning

confidence: 99%

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Validation of a portable monitor compared with polysomnography for screening of obstructive sleep apnea in polio survivors

Ding

Liu

et al. 2023

Front. Neurol.

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SubjectiveSleep-disordered breathing (SDB) is highly prevalent in polio survivors. Obstructive sleep apnea (OSA) is the most frequent type. Full polysomnography (PSG) is recommended for OSA diagnosis in patients with comorbidities by current practice guidelines, but it is not always accessible. The purpose of this study was to evaluate whether type 3 portable monitor (PM) or type 4 PM might be a viable alternative to PSG for the diagnosis of OSA in postpolio subjects.MethodsA total of 48 community-living polio survivors (39 men and 9 women) with an average age of 54.4 ± 5.3 years referred for the evaluation of OSA and who volunteered to participate were recruited. First, they completed the Epworth Sleepiness Scale (ESS) questionnaire and underwent pulmonary function testing and blood gas tests the day before PSG night. Then, they underwent an overnight in-laboratory PSG with a type 3 PM and type 4 PM recording simultaneously.ResultsThe AHI from PSG, respiratory event index (REI) from type 3 PM, and ODI3 from type 4 PM was 30.27 ± 22.51/h vs. 25.18 ± 19.11/h vs. 18.28 ± 15.13/h, respectively (P < 0.001). For AHI ≥ 5/h, the sensitivity and specificity of REI were 95.45 and 50%, respectively. For AHI ≥ 15/h, the sensitivity and specificity of REI were 87.88% and 93.33%, respectively. The Bland–Altman analysis of REI on PM vs. AHI on PSG showed a mean difference of −5.09 (95% confidence interval [CI]: −7.10, −3.08; P < 0.001) with limits of agreement ranging from −18.67 to 8.49 events/h. ROC curve analysis for patients with REI ≥ 15/h showed an area under the curve (AUC) of 0.97. For AHI ≥ 5/h, the sensitivity and specificity of ODI3 from type 4 PM were 86.36 and 75%, respectively. For patients with AHI ≥ 15/h, the sensitivity was 66.67%, and the specificity was 100%.ConclusionType 3 PM and Type 4 PM could be alternative ways to screen OSA for polio survivors, especially for moderate to severe OSA.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Validation of a portable monitor compared with polysomnography for screening of obstructive sleep apnea in polio survivors

Ding

Liu

et al. 2023

Front. Neurol.

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“…Deve-se salientar que, em relação ao uso de métodos domiciliares no diagnóstico dos DRS em pacientes com doenças neuromusculares, existem estudos que sugerem que até a oximetria noturna seria capaz de avaliar esses pacientes, principalmente quando não é factível a realização da PSG. (138,139) 4) Uma segunda PSG deve ser realizada quando a primeira é negativa e permanece a forte suspeita de AOS (recomendação fraca). 5) Os questionários não devem ser usados isoladamente para o diagnóstico de AOS, sendo sempre recomendado um teste objetivo do sono (PSG ou poligrafia; recomendação forte).…”

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Brazilian Thoracic Association Consensus on Sleep-disordered Breathing

et al. 2022

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Sleep is essential for the proper functioning of all individuals. Sleep-disordered breathing can occur at any age and is a common reason for medical visits. The objective of this consensus is to update knowledge about the main causes of sleep-disordered breathing in adult and pediatric populations, with an emphasis on obstructive sleep apnea. Obstructive sleep apnea is an extremely prevalent but often underdiagnosed disease. It is often accompanied by comorbidities, notably cardiovascular, metabolic, and neurocognitive disorders, which have a significant impact on quality of life and mortality rates. Therefore, to create this consensus, the Sleep-Disordered Breathing Department of the Brazilian Thoracic Association brought together 14 experts with recognized, proven experience in sleep-disordered breathing.

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Nocturnal oximetry in the diagnosis of obstructive sleep apnea syndrome in potentially hypoxic patients due to neuromuscular diseases

Cited by 2 publications

References 29 publications

Validation of a portable monitor compared with polysomnography for screening of obstructive sleep apnea in polio survivors

Validation of a portable monitor compared with polysomnography for screening of obstructive sleep apnea in polio survivors

Brazilian Thoracic Association Consensus on Sleep-disordered Breathing

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