Prediction of the Apnea-Hypopnea Index From Overnight Pulse Oximetry *

Magalang, Ulysses J.; Dmochowski, Jacek; Veeramachaneni, Sateesh; Draw, Azmi; Mador, M. Jeffery; El-Solh, Ali; Grant, Brydon J. B.

doi:10.1378/chest.124.5.1694

Cited by 180 publications

(177 citation statements)

References 30 publications

(38 reference statements)

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“…While these measures are not equal, they have been found to be comparable when combined with appropriate clinical assessment. 22,23,46,47 Both polysomnography and overnight oximetry are acceptable methods of diagnosing OSA when used appropriately, and we believe our results remain clinically relevant. Secondly, we did not have mood data on 26.7% of the sample, due to the patient's non-English speaking background or administrative error.…”

Section: Limitationsmentioning

confidence: 57%

Depression May Reduce Adherence during CPAP Titration Trial

Law

Naughton

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objectives: Depression is a risk factor for medication non-compliance. We aimed to identify if depression is associated with poorer adherence during home-based autotitrating continuous positive airway pressure (autoPAP) titration. Design: Mixed retrospective-observational study. Setting: Academic center. Participants: Two-hundred forty continuous positive airway pressure-naïve obstructive sleep apnea (OSA) patients. Measurements:Patients underwent approximately 1 week of home-based autoPAP titration with adherence data downloaded from the device. Electronic hospital records were reviewed in a consecutive manner for inclusion. Three areas of potential predictors were examined: (i) demographics and clinical factors, (ii) disease severity, and (iii) device-related variables. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS). Scores on the subscales were categorized as normal or clinical diagnoses of depression (≥ 8) and anxiety (≥ 11). The primary outcome variable was the mean hours of autoPAP used per night. th percentile pressure and autoPAP use. Conclusion: Depression was independently associated with poorer adherence during home-based autoPAP titration. Depression may be a potential target for clinicians and future research aimed at enhancing adherence to autoPAP therapy.

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Section: Limitationsmentioning

confidence: 57%

Depression May Reduce Adherence during CPAP Titration Trial

Law

Naughton

et al. 2014

Journal of Clinical Sleep Medicine

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“…In the first place, not all studies are based on the same definition of AHI. For example, some previous studies conservatively employ values of AHI ≥ 15 events/hour (Ryan et al 1995, Lévy et al 1996, Lacassagne et al 1997, Sano et al 1998, Olson et al 1999, Magalang et al 2003, whereas others use AHI ≥ 5 events/hour to diagnose mild OSA (Chaudhary et al 1998, Littner 2000, Fernández et al 2004. We used a threshold of AHI ≥ 10 events/hour.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, we have developed a computer program to compute the delta index (∆ index). This is a common measure of signal variability usually applied by researchers (Lévy et al 1996, Olson et al 1999, Magalang et al 2003. The ∆ index was computed as the sum of the absolute variations between two successive points, divided by the number of intervals (Lévy et al 1996).…”

Section: Classical Oximetry Indexesmentioning

confidence: 99%

“…The ∆ index was computed as the sum of the absolute variations between two successive points, divided by the number of intervals (Lévy et al 1996). Although the ∆ index is usually computed for 12 seconds intervals (Lévy et al 1996, Olson et al 1999, Magalang et al 2003, we used 10 seconds intervals because of our sampling frequency.…”

Section: Classical Oximetry Indexesmentioning

confidence: 99%

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Nonlinear characteristics of blood oxygen saturation from nocturnal oximetry for obstructive sleep apnoea detection

Álvarez¹,

Hornero²,

Abásolo³

et al. 2006

Physiol. Meas.

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Nocturnal oximetry is an attractive option for the diagnosis of obstructive sleep apnoea (OSA) syndrome because of its simplicity and low cost compared to polysomnography (PSG). The present study assesses non-linear analysis of blood oxygen saturation (SaO 2 ) from nocturnal oximetry as a diagnostic test to discriminate between OSA positive and OSA negative patients. A sample of 187 referred outpatients, clinically suspected of having OSA, were studied using nocturnal oximetry performed simultaneously with complete PSG. A positive OSA diagnosis was found for 111 cases, while the remaining 76 cases were classified as OSA negative. The following oximetric indexes were obtained: cumulative time spent below a saturation of 90% (CT90), oxygen desaturation indexes of 4% (ODI4), 3% (ODI3) and 2% (ODI2), and the delta index (∆ index). SaO 2 records were subsequently processed applying two non-linear methods: central tendency measure (CTM) and Lempel-Ziv (LZ) complexity. Significant differences (p < 0.01) were found between OSA positive and OSA negative patients. Using CTM we obtained a sensitivity of 90.1% and a specificity of 82.9%, while with LZ the sensitivity was 86.5% and the specificity was 77.6%. CTM and LZ accuracy was higher than that provided by ODI4, ODI3, ODI2 and CT90. The results suggest that non-linear analysis of SaO 2 signals from nocturnal oximetry could yield useful information in OSA diagnosis.

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“…In SpO 2 , zero values and differences between consecutive samples ! 4% were removed and substituted by interpolated data [14]. In PRV, values <0.33 s or >1.5 s, as well as differences in consecutive PRV values >0.66, were considered arrhythmia-related artifacts [4].…”

Section: Subjects and Signalsmentioning

confidence: 99%

Pulse Rate Variability Analysis to Enhance Oximetry as at-Home Alternative for Sleep Apnea Diagnosing

et al. 2018

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This study focuses on the at-home Sleep apnea-hypopnea syndrome (SAHS) severity estimation. Three percent oxygen desaturation index ðODI 3 Þ from nocturnal pulse-oximetry has been commonly evaluated as simplified alternative to polysomnography (PSG), the standard in-hospital diagnostic test. However, ODI 3 has shown limited ability to detect SAHS as it only sums up information from desaturation events. Other physiological signs of SAHS can be found in respiratory and cardiac signals, providing additional helpful data to establish SAHS and its severity. Pulse rate variability time series (PRV), also derived from nocturnal oximetry, is considered a surrogate for heart rate variability, which provides both cardiac and respiratory information. In this study, 200 oximetric recordings obtained at patients home were involved, divided into training (50%) and test (50%) groups. ODI 3 and PRV were obtained from them, the latter being characterized by the extraction of statistical features in time domain, as well as the spectral entropy from the commonly used very low (0-0.04 Hz.), low (0.04-0.15 Hz.), and high (0.15-0.4 Hz.) frequency bands. The ODI 3 and PRV features were joined in a multi-layer perceptron artificial neural network (MLP), trained to estimate the apnea-hypopnea index (AHI), which is the PSG-derived parameter used to diagnose SAHS. Our results showed that single ODI 3 rightly assigned 62.0% of the subjects from the test group into one out the four SAHS severity degrees, reaching 0.470 Cohens kappa, and 0.840 intra-class correlation coefficient (ICC) with the actual AHI (accuracies of 90.0, 88.0 and 82.0% in the increasing AHI cutoffs used to define SAHS severity). By contrast, our MLP model rightly assigned 75.0% of the subjects into their corresponding SAHS severity level, reaching 0.614 j and 0.904 ICC (accuracies of 93.0, 88.0 and 90.0%). These results suggest that SAHS diagnosis could be accurately conducted at-patients home by combining ODI 3 and PRV from nocturnal oximetry Keywords

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Prediction of the Apnea-Hypopnea Index From Overnight Pulse Oximetry *

Cited by 180 publications

References 30 publications

Depression May Reduce Adherence during CPAP Titration Trial

Depression May Reduce Adherence during CPAP Titration Trial

Nonlinear characteristics of blood oxygen saturation from nocturnal oximetry for obstructive sleep apnoea detection

Pulse Rate Variability Analysis to Enhance Oximetry as at-Home Alternative for Sleep Apnea Diagnosing

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