A comprehensive evaluation of a two-channel portable monitor to "rule in" obstructive sleep apnea
© 2015, American Academy of Sleep Medicine. All rights reserved. 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...
| Main Authors: | , , , , , , , , , |
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| Format: | Journal Article |
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2015
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| Online Access: | http://hdl.handle.net/20.500.11937/66875 |
| _version_ | 1848761415507116032 |
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| author | Ward, Kim McArdle, N. James, A. Bremner, A. Simpson, L. Cooper, M. Palmer, L. Fedson, A. Mukherjee, S. Hillman, D. |
| author_facet | Ward, Kim McArdle, N. James, A. Bremner, A. Simpson, L. Cooper, M. Palmer, L. Fedson, A. Mukherjee, S. Hillman, D. |
| author_sort | Ward, Kim |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 2015, American Academy of Sleep Medicine. All rights reserved. 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. |
| first_indexed | 2025-11-14T10:31:19Z |
| format | Journal Article |
| id | curtin-20.500.11937-66875 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:31:19Z |
| publishDate | 2015 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-668752018-05-18T08:07:10Z A comprehensive evaluation of a two-channel portable monitor to "rule in" obstructive sleep apnea Ward, Kim McArdle, N. James, A. Bremner, A. Simpson, L. Cooper, M. Palmer, L. Fedson, A. Mukherjee, S. Hillman, D. © 2015, American Academy of Sleep Medicine. All rights reserved. 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. 2015 Journal Article http://hdl.handle.net/20.500.11937/66875 10.5664/jcsm.4600 restricted |
| spellingShingle | Ward, Kim McArdle, N. James, A. Bremner, A. Simpson, L. Cooper, M. Palmer, L. Fedson, A. Mukherjee, S. Hillman, D. A comprehensive evaluation of a two-channel portable monitor to "rule in" obstructive sleep apnea |
| title | A comprehensive evaluation of a two-channel portable monitor to "rule in" obstructive sleep apnea |
| title_full | A comprehensive evaluation of a two-channel portable monitor to "rule in" obstructive sleep apnea |
| title_fullStr | A comprehensive evaluation of a two-channel portable monitor to "rule in" obstructive sleep apnea |
| title_full_unstemmed | A comprehensive evaluation of a two-channel portable monitor to "rule in" obstructive sleep apnea |
| title_short | A comprehensive evaluation of a two-channel portable monitor to "rule in" obstructive sleep apnea |
| title_sort | comprehensive evaluation of a two-channel portable monitor to "rule in" obstructive sleep apnea |
| url | http://hdl.handle.net/20.500.11937/66875 |