Predicitve Value Of Automated Oxygen Saturation Analysis For The Diagnosis And Treatment Of Obstructive Sleep Apnea In A Home-Based Setting

Abstract

Background: A portable monitor for the automated analysis of episodic nocturnal oxygen saturation or SpO2 (the Remmers Sleep Recorder, RSR) was proposed for the diagnosis of obstructive sleep apnea-hypopnea (OSAH). The purpose of this study was to compare the diagnostic performance of automated analysis with the manual scoring of polygraphic data by a more comprehensive respiratory monitor (the Suzanne recorder) used simultaneously in their intended home environment.

Methods: The respiratory disturbance indexes of the 2 monitors were compared in 94 consecutive adult patients suspected of having OSAH and who were deemed eligible for home-based investigation.

Results: The RSR overestimated the number of respiratory events associated with ≥4% fall in SpO2 by 13% (p<.005), but underestimated the number of apneas and hypopneas defined on the basis of respiratory variables alone or their association with ≥4% fall in SpO2 or autonomic arousals, by 38% to 48% (p<.0001). In addition to these significant biases, the limits of agreement in all instances were wide, indicating a poor concurrence between the 2 monitors.

Conclusion: The automated analysis of SpO2 with the RSR cannot be substituted for the manual scoring of polygraphic data with the more comprehensive respiratory monitor in the diagnosis of OSAH in an ambulatory home-based setting.