Comparison of Polysomnographic and Portable Home Monitoring Assessments of Obstructive Sleep Apnea in Saskatchewan Women
Open accessAbstract
OBJECTIVES: To compare a commercially available, level III in‐home diagnostic sleep test (Embletta, Embletta USA) and in‐laboratory polysomnography (PSG) in women with suspected obstructive sleep apnea (OSA). METHODS: Consecutive women scheduled for routine PSG testing for evaluation of clinically suspected OSA and who met inclusion/exclusion criteria, were invited to participate. An in‐home Embletta portable monitor test was performed one week before or after diagnostic PSG. RESULTS: Forty‐seven of 96 women who met the inclusion/exclusion criteria agreed to participate. The mean (± SD) age of the patients was 52.0±11.0 years, with a mean body mass index of 34.86±9.04 kg/m 2 , and 66% (31 of 47) of patients were at high risk for OSA according to the Berlin score. Paired analysis of the overall population revealed no significant difference in mean apnea/hypopnea index (AHI) between the two diagnostic methods (P=0.475). At an AHI of ≥5, the Embletta test was highly sensitive (90.6%) in determining abnormal versus normal OSA, with a positive predictive value of 82.7%. However, a higher Embletta AHI threshold of ≥10 may be more useful, with a higher level of agreement (kappa coefficient) with PSG testing and a positive predictive value of 92.3%. The in‐home study was less useful at distinguishing severe from nonsevere OSA, yielding a sensitivity of 50%. CONCLUSIONS: In women believed to be at high‐risk for OSA, Embletta in‐home sleep testing is useful for the detection of sleep disordered breathing.
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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 [87]
The Discussion and Table 2 evaluate a level III home monitor at an AHI cutoff of 5, so the test type and cutoff are supported. The paper reports results from 47 women, not accuracy ranges across seven studies or calculations assuming 87% and 55% prevalence; those figures are not supported by this source. Page numbers are not specified in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredUsing 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 [87]
The Discussion (page not provided) evaluates an in-home Embletta test at an AHI cutoff of 15 in women considered at high clinical risk of OSA. It reports sensitivity of 0.63 and specificity of 0.93, not an accuracy range of 65%–91% based on six studies. The Results (page not provided) report an accuracy of 80.9% for a different threshold, AHI ≥30. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSeven 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 [87]
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- Authors
- Gjevre, J., Taylor-Gjevre, R., Skomro, R., Reid, J., Fenton, M., & Cotton, D.
- Venue
- Canadian Respiratory Journal
- Publisher
- Wiley
- Published
- 2011-01
- Volume
- 18
- Issue
- 5
- Pages
- 271-274
- ISSN
- 1198-2241 (ISSN-L)
- 1916-7245
- PMC
- PMC3267604
- OpenAlex
- W201196720
- Cited by
- 40
- References
- 0
- Citations by year
- 2026: 2 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 3 · 2019: 1 · 2018: 4 · 2017: 3 · 2016: 1 · 2015: 1 · 2014: 5 · 2013: 5 · 2012: 2
- FWCI
- 2.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Canadian Respiratory Journal (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Saskatchewan Health Research Foundation
- Topics
- Health Sciences › Medicine › Physiology › 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, home sleep testing, polysomnography, women, diagnostic accuracy, apnea-hypopnea index, sleep-disordered breathing, OSA severity, positive predictive value, sensitivity
- MeSH terms
- Adult, Aged, Female, Humans, Middle Aged, Monitoring, Physiologic, Prospective Studies, ROC Curve, Saskatchewan, Self Care, Sensitivity and Specificity, Polysomnography, Sleep Apnea, Obstructive, Young Adult
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