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Nasal pressure recordings to detect obstructive sleep apnea
Fernanda Ribeiro de Almeida1, Najib T Ayas, Ryo Otsuka
1Division of Orthodontics, Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, Canada, V6T 1Z3. falmeida@interchange.ubc.ca
Sleep & Breathing = Schlaf & Atmung
|February 28, 2006
Summary
A new device, SleepCheck, shows promise for diagnosing obstructive sleep apnea (OSA) at home. While it initially overestimates breathing events, its corrected accuracy is comparable to other portable sleep apnea testing devices.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
Background:
- Obstructive sleep apnea (OSA) is a prevalent condition requiring accurate diagnosis.
- In-laboratory polysomnography (PSG) is the gold standard but is costly and less accessible.
- Ambulatory diagnostic methods are needed to improve OSA detection rates.
Purpose of the Study:
- To evaluate the diagnostic performance of the SleepCheck device for identifying patients with sleep apnea.
- To compare SleepCheck's respiratory disturbance index (RDI) with the apnea-hypopnea index (AHI) from standard PSG.
Main Methods:
- A prospective study involving 30 patients with suspected OSA.
- Simultaneous in-laboratory PSG and SleepCheck monitoring during a full diagnostic night.
- Comparison of RDI from SleepCheck against AHI from PSG, analyzing correlations and diagnostic accuracy.
Main Results:
- SleepCheck systematically overestimated respiratory events compared to PSG (mean difference: 27.4 events/hour).
- Overscoring was partly due to normal physiological flow changes during REM sleep and arousals.
- A strong correlation was found between SleepCheck RDI and PSG AHI (r=0.805).
- Receiver operating characteristic analysis showed high areas under the curve (AUCs) of 0.915 and 0.910 for AHI thresholds of 10 and 20/h, respectively.
- Optimal sensitivity and specificity were 86.4%/75.0% and 88.9%/81.0% for these thresholds.
Conclusions:
- Despite overscoring respiratory events, SleepCheck demonstrates reasonable diagnostic accuracy after bias correction.
- The device's performance, including AUC, sensitivity, and specificity, is comparable to other type 4 ambulatory monitoring devices.
- SleepCheck offers a potentially valuable tool for the ambulatory diagnosis of sleep apnea.