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Cited by 39Obstructive Sleep Apnea ResearchSleep and related disordersChronic Obstructive Pulmonary Disease (COPD) Research

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A Comprehensive Evaluation of a Two-Channel Portable Monitor to “Rule in” Obstructive Sleep Apnea

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Ward, Kim L., McArdle, Nigel, James, Alan, Bremner, Alexandra P., Simpson, Laila, Cooper, Matthew N., Palmer, Lyle J., Fedson, Annette C., Mukherjee, Sutapa, Hillman, David R.·2015·Journal of Clinical Sleep Medicine
DOI 10.5664/jcsm.4600PMC PMC4365457
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Abstract

Study objectives We hypothesized that a dual-channel portable monitor (PM) device could accurately identify patients who have a high pretest probability of obstructive sleep apnea (OSA), and we evaluated factors that may contribute to variability between PM and polysomnography (PSG) results. Methods Consecutive clinic patients (N = 104) with possible OSA completed a home PM study, a PM study simultaneous with laboratory PSG, and a second home PM study. Uniform data analysis methods were applied to both PM and PSG data. Primary outcomes of interest were the positive likelihood ratio (LR+) and sensitivity of the PM device to "rule-in" OSA, defined as an apnea-hypopnea index (AHI) ≥ 5 events/h on PSG. Effects of different test environment and study nights, and order of study and analysis methods (manual compared to automated) on PM diagnostic accuracy were assessed. Results The PM has adequate LR+ (4.8), sensitivity (80%), and specificity (83%) for detecting OSA in the unattended home setting when benchmarked against laboratory PSG, with better LR+ (> 5) and specificity (100%) and unchanged sensitivity (80%) in the simultaneous laboratory comparison. There were no significant night-night (all p > 0.10) or study order effects (home or laboratory first, p = 0.08) on AHI measures. Manual PM data review improved case finding accuracy, although this was not statistically significant (all p > 0.07). Misclassification was more frequent where OSA was mild. Conclusions Overall performance of the PM device is consistent with current recommended criteria for an "acceptable" device to confidently "rule-in" OSA (AHI ≥ 5 events/h) in a high pretest probability clinic population. Our data support the utility of simple two-channel diagnostic devices to confirm the diagnosis of OSA in the home environment. Commentary A commentary on this article appears in this issue on page 411.

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Metadata

Authors
Ward, K. L., McArdle, N., James, A., Bremner, A. P., Simpson, L., Cooper, M. N., Palmer, L. J., Fedson, A. C., Mukherjee, S., & Hillman, D. R.
Affiliations
  • The University of Western Australia (AU)
  • Sir Charles Gairdner Hospital (AU)
  • The Kids Research Institute Australia (AU)
  • The University of Adelaide (AU)
  • University of Pennsylvania (US)
  • West Australian Sleep Disorders Research Institute (AU)
Corresponding author
Ward, Kim L.
ORCID
Venue
Journal of Clinical Sleep Medicine
Publisher
Springer Science and Business Media LLC
Published
2015-04-15
Volume
11
Issue
4
Pages
433-444
ISSN
  • 1550-9389 (ISSN-L)
  • 1550-9397
DOI
10.5664/jcsm.4600
PMC
PMC4365457
OpenAlex
W1975564532
Cited by
39
References
1
Citations by year
2024: 1 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 7 · 2019: 6 · 2018: 5 · 2017: 7 · 2016: 4 · 2015: 3
FWCI
4.23
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Sleep Medicine (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • UWA Profiles and Research Repository (UWA) (submittedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
  • eSpace (Curtin University) (submittedVersion)
Funders
ResMed
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, home sleep testing, polysomnography comparison, diagnostic accuracy, positive likelihood ratio, apnea-hypopnea index
MeSH terms
Female, Humans, Male, Middle Aged, Monitoring, Physiologic, Reproducibility of Results, Polysomnography, Sleep Apnea, Obstructive

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