Diagnosis of Obstructive Sleep Apnea Syndrome and Its Outcomes With Home Portable Monitoring
Abstract
Background The use of portable respiratory monitoring (PM) has been proposed for the diagnosis of obstructive sleep apnea syndrome (OSAS), but most studies that validate PM accuracy have not followed the best standards for diagnostic test validation. The objective of the present study was to evaluate the accuracy of PM performed at home to diagnose OSAS and its outcomes after first validating PM in the laboratory setting by comparing it to polysomnography (PSG). Methods Patients with suspected OSAS were submitted, in random order, to PM at the sleep laboratory concurrently with PSG (lab-PM) or at home-PM. The diagnostic performance was assessed by sensitivity, specificity, positive and negative predictive values, positive likelihood ratio (+LR), negative likelihood ratio (-LR), intraclass correlation coefficients, kappa statistic, and Bland-Altman plot. Results One hundred fifty-seven subjects (73% men, mean age +/- SD, 45 +/- 12 yr) with an apnea-hypopnea index (AHI) of 31 (SD +/- 29) events/h were studied. Excluding inadequate recordings, 149 valid comparisons with lab-PM and 121 with unattended home-PM were obtained. Compared to PSG for detecting AHI > 5, the lab-PM demonstrated sensitivity of 95.3%, specificity of 75%, +LR of 3.8, and -LR of 0.11; the home-PM exhibited sensitivity of 96%, specificity of 64%, +LR of 2.7, and -LR of 0.05. Kappa statistics indicated substantial correlation between PSG and PM results. Bland-Altman plot showed smaller dispersion for lab-PM tha…
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In a high-risk population using cutoffs of AHI ≥ 5, AHI ≥ 15 and AHI ≥ 30, accuracy of 2-3 channel HSAT devices ranged from 81% to 93%, 72% to 87%, and 71% to 90%, respectively.
“In a high-risk population using cutoffs of AHI ≥ 5,95–97 AHI ≥ 15,95–99 and AHI ≥ 30,96,97 accuracy ranged from 81% to 93%, 72% to 87%, and 71% to 90%, respectively.”
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 [96]
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- Authors
- de Oliveira, A. C. T., Martinez, D., Vasconcelos, L. F. T., Cadaval Gonçalves, S., do Carmo Lenz, M., Costa Fuchs, S., Gus, M., de Abreu-Silva, E. O., Beltrami Moreira, L., & Danni Fuchs, F.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2009-02
- Volume
- 135
- Issue
- 2
- Pages
- 330-336
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W2108696608
- Cited by
- 129
- References
- 2
- Citations by year
- 2026: 1 · 2024: 5 · 2023: 3 · 2022: 7 · 2021: 5 · 2020: 14 · 2019: 5 · 2018: 7 · 2017: 10 · 2016: 7 · 2015: 10 · 2014: 8 · 2013: 11 · 2012: 13
- FWCI
- 7.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- 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, diagnostic accuracy, apnea-hypopnea index, diagnostic test validation, likelihood ratios, kappa statistic, Bland-Altman agreement
- MeSH terms
- Adult, Female, Home Care Services, Humans, Male, Middle Aged, Monitoring, Physiologic, ROC Curve, Sensitivity and Specificity, Sleep Apnea Syndromes, Confidence Intervals, Polysomnography, Risk Assessment, Monitoring, Ambulatory
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