Sleep disordered breathing analysis in a general population using standard pulse oximeter signals

Area of Science:

• Cardiorespiratory Sleep Medicine
• Biomedical Signal Processing
• Diagnostic Technology

Background:

• Obstructive sleep apnea diagnosis typically requires extensive polysomnography (PSG) in sleep laboratories.
• A simpler, more accessible diagnostic method is needed for widespread screening and home-based evaluations.
• Photoplethysmograph (PPG) signals offer potential for non-invasive sleep apnea assessment.

Purpose of the Study:

• To evaluate a standard pulse oximeter system with automated PPG signal analysis for diagnosing sleep disordered breathing (SDB).
• To compare the accuracy of this system against the gold standard full polysomnography (PSG).
• To assess the feasibility of using this device for convenient, out-of-center diagnosis or screening.

Main Methods:

• 140 patients referred for SDB diagnosis underwent overnight PSG in an accredited sleep laboratory.
• Pulse oximeter and PPG signals were recorded throughout the night as part of the PSG.
• Apnea-hypopnea index (AHI) from automated PPG analysis was compared to AHI from manual PSG scoring.

Main Results:

• The AHI and total respiratory events measured by pulse oximeter analysis showed strong correlation with full PSG.
• Sensitivity and specificity for detecting AHI levels of ≥5 and ≥15 were both above 90%.
• Sensitivity and positive predictive value for detecting respiratory events exceeded 84%.

Conclusions:

• The automated pulse oximeter system provides acceptable accuracy for diagnosing moderate to severe sleep apnea compared to PSG.
• The system's convenience and simplicity make it suitable for home and ambulatory screening of SDB.
• This approach offers a practical alternative for broader patient access to sleep disorder diagnosis.