Validation of a portable monitor compared with polysomnography for screening of obstructive sleep apnea in polio survivors

Frontiers in Neurology

Neurology

Jinxian Wu¹  Jianghua Liu²  Ting Sun²  Xiao Li²  Changjun Lv²  Jingyu Wang²  Yunliang Sun²  Meng Wang²  Fang Han³  Xiaosong Dong³  Chi Zhang³  Qidi Ding³  Juan Du⁴  Yan Yu⁵  Kingman P. Strohl⁶ 

[1] Department of Pediatric, Dongyang People's Hospital, Jinhua, Zhejiang, China;Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, Shandong, China;Department of Respiratory and Sleep Medicine, Peking University People's Hospital, Beijing, China;Department of Sleep Medicine, Dongyang Seventh People's Hospital, Jinhua, Zhejiang, China;Department of the First School of Clinical Medicine, Binzhou Medical University, Binzhou, Shandong, China;Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Case Western Reserve University, and Cleveland Louis Stokes VA Medical Center, Cleveland, OH, United States;

关键词: sleep-disordered breathing;    obstructive sleep apnea;    postpolio;    neuromuscular disorder;    portable monitor;   

DOI  :  10.3389/fneur.2023.1137535

 received in 2023-01-04, accepted in 2023-04-12,  发布年份 2023

来源: Frontiers

【 摘 要 】

SubjectiveSleep-disordered breathing (SDB) is highly prevalent in polio survivors. Obstructive sleep apnea (OSA) is the most frequent type. Full polysomnography (PSG) is recommended for OSA diagnosis in patients with comorbidities by current practice guidelines, but it is not always accessible. The purpose of this study was to evaluate whether type 3 portable monitor (PM) or type 4 PM might be a viable alternative to PSG for the diagnosis of OSA in postpolio subjects.MethodsA total of 48 community-living polio survivors (39 men and 9 women) with an average age of 54.4 ± 5.3 years referred for the evaluation of OSA and who volunteered to participate were recruited. First, they completed the Epworth Sleepiness Scale (ESS) questionnaire and underwent pulmonary function testing and blood gas tests the day before PSG night. Then, they underwent an overnight in-laboratory PSG with a type 3 PM and type 4 PM recording simultaneously.ResultsThe AHI from PSG, respiratory event index (REI) from type 3 PM, and ODI3 from type 4 PM was 30.27 ± 22.51/h vs. 25.18 ± 19.11/h vs. 18.28 ± 15.13/h, respectively (P < 0.001). For AHI ≥ 5/h, the sensitivity and specificity of REI were 95.45 and 50%, respectively. For AHI ≥ 15/h, the sensitivity and specificity of REI were 87.88% and 93.33%, respectively. The Bland–Altman analysis of REI on PM vs. AHI on PSG showed a mean difference of −5.09 (95% confidence interval [CI]: −7.10, −3.08; P < 0.001) with limits of agreement ranging from −18.67 to 8.49 events/h. ROC curve analysis for patients with REI ≥ 15/h showed an area under the curve (AUC) of 0.97. For AHI ≥ 5/h, the sensitivity and specificity of ODI3 from type 4 PM were 86.36 and 75%, respectively. For patients with AHI ≥ 15/h, the sensitivity was 66.67%, and the specificity was 100%.ConclusionType 3 PM and Type 4 PM could be alternative ways to screen OSA for polio survivors, especially for moderate to severe OSA.

【 授权许可】

Unknown   
Copyright © 2023 Ding, Liu, Wu, Du, Li, Wang, Sun, Yu, Wang, Sun, Zhang, Lv, Strohl, Han and Dong.