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Is portable monitoring for diagnosing obstructive sleep apnea syndrome suitable in elderly population?
Abstract
Purpose Obstructive sleep apnea syndrome (OSAS) is highly prevalent in the elderly. Unattended, at-home portable monitoring (PM) is a diagnostic alternative to polysomnography in adults with high clinical probability of OSAS. However, no studies have evaluated the diagnostic accuracy of PM in elderly population. The aim of our study was to evaluate the effectiveness of PM in elderly patients. Methods We selected patients aged over 65 years with suspected OSAS. Two-order randomized evaluations were performed: one night of at-home PM (PMhome) and one night of simultaneous PM and polysomnography (PSG) in the sleep lab (PSG+PM). We obtained three different apnea-hypopnea index (AHI): AHI from PSG (AHI PSG), AHI from at-home PM (AHI PMhome), and AHI from PM+PSG (AHI PM+PSG). Two technicians, blinded to the recording order, scored each sleep study. Results We studied a total of 43 patients. No difference between the AHI values for each of the different recordings was found (p > 0.05). There was good correlation between AHI PSG and AHI PMhome (r = 0.67) and AHI PSG+PM (r = 0.84). The area under the receiver operator curve was above 0.83, indicating good sensitivity and a positive predictive value for AHI with cutoffs of 5, 15, and 30 and good specificity and negative predictive value for AHI values above 15. Correlation, accuracy, and agreement were greater when the recordings were made simultaneously. Conclusions PM was effective for diagnosing OSAS in the elderly and can be used a…
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When using an AHI ≥ 5 cutoff, accuracy of Type 3 HSAT devices in a high-risk population (assuming a prevalence of 87%) ranged from 84% to 91%, whereas in a low-risk population (assuming a prevalence of 55%) accuracy ranged from 70% to 78%.
“When using an AHI ≥ 5 cutoff, accuracy in a high-risk population (assuming a prevalence of 87%) ranged from 84% to 91%, whereas in a low-risk population (assuming a prevalence of 55%) accuracy ranged from 70% to 78% based on the seven studies”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [89]
Using a cutoff of AHI ≥ 15, the accuracy of Type 3 HSAT devices in a high-risk population ranged from 65% to 91%, based on six studies.
“Using a cutoff of AHI ≥ 15, the accuracy of these devices in a high-risk population ranged from 65% to 91%, based on six studies”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [89]
Seven studies evaluated the performance of Type 3 HSAT devices against PSG, with AHI cutoffs varying across studies.
“Seven studies evaluated the performance of Type 3 HSAT devices against PSG, but the AHI cutoffs employed varied across studies, resulting in sub-grouping by AHI cutoffs for our analyses.”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [89]
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Metadata
- Authors
- Polese, J. F., Santos-Silva, R., de Oliveira Ferrari, P. M., Sartori, D. E., Tufik, S., & Bittencourt, L.
- Affiliations
- Universidade Federal de São Paulo (BR)
- Corresponding author
- Bittencourt, Lia
- Venue
- Sleep and Breathing
- Published
- 2012-07-04
- Volume
- 17
- Issue
- 2
- Pages
- 679-686
- ISSN
- 1520-9512 (ISSN-L)
- 1522-1709
- OpenAlex
- W2029000554
- Cited by
- 32
- References
- 50
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 1 · 2022: 5 · 2021: 3 · 2020: 1 · 2019: 3 · 2018: 1 · 2017: 4 · 2016: 2 · 2015: 1 · 2014: 3 · 2013: 3
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Sleep And Breathing (publishedVersion)
- PubMed (publishedVersion)
- UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion)
- Funders
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- obstructive sleep apnea, portable monitoring, home sleep testing, elderly patients, diagnostic accuracy, apnea-hypopnea index, polysomnography, diagnostic thresholds
- MeSH terms
- Age Factors, Aged, Cross-Sectional Studies, Equipment Design, Female, Humans, Male, Predictive Value of Tests, Polysomnography, Monitoring, Ambulatory, Sleep Apnea, Obstructive
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