Validation of Oximetry for Diagnosing Obstructive Sleep Apnea in a Clinical Setting

A large epidemiological study using oximetry to analyze obstructive sleep apnea (OSA) and metabolic comorbidities was performed in Japan; however, reliability and validity of oximetry in the Japanese population remains poorly understood. In this study, oximetry data from the epidemiological study were compared with data from clinically performed polysomnography (PSG) and out-of-center sleep testing (OCST) in epidemiological study participants who later attended our outpatient units. The oxygen desaturation index (ODI) from oximetry showed a moderate positive relationship (correlation coefficient r = 0.561, p < 0.001) with apnea/hypopnea data from PSG/OCST. The area under the receiver operating characteristic curve showed moderate accuracy of this method in the detection of moderate-to-severe or severe OSA. However, the optimal ODI thresholds to detect moderate-to-severe OSA and severe OSA were the same (ODI > 20.1). Oximetry may be a useful tool for screening moderate-to-severe or severe sleep apnea. However, it may be difficult to set an appropriate threshold to distinguish between moderate and severe sleep apnea by oximetry alone.