Comparison of Two Home Sleep Testing Devices with Different Strategies for Diagnosis of OSA

Details

• Personal Author:
  Alimokhtari S ; Ayappa I ; Black K ; Gumb T ; Perez A ; Rapoport DM ; Sunderram J ; Twumasi A
• Description:
  PURPOSE: Home sleep testing devices are being widely used in diagnosis/screening for obstructive sleep apnea (OSA). We examined differences in OSA metrics obtained from two devices with divergent home monitoring strategies, the Apnea Risk Evaluation System (ARESTM, multiple signals plus forehead reflectance oximetry) and the Nonin WristOx2TM (single channel finger transmission pulse oximeter), compared to differences from night-night variability of OSA. METHODS: One hundred fifty-two male/26 female subjects (BMI = 30.3 +/- 5.6 kg/m2, age = 52.5 +/- 8.9 years) were recruited without regard to OSA symptoms and simultaneously wore both ARESTM and Nonin WristOx2TM for two nights (n = 351 nights). Automated analysis of the WristOx2 yielded oxygen desaturation index (ODIOx2, >4% O2 dips/h), and automated analysis with manual editing of ARESTM yielded AHI4ARES (apneas + hypopneas with >4% O2 dips/h) and RDIARES (apneas + hypopneas with >4% O2 dips/h or arousal surrogates). Baseline awake oxygen saturation, percent time < 90% O2 saturation (%time < 90%O2Sat), and O2 signal loss were compared between the two methods. RESULTS: Correlation between AHI4ARES and ODIOx2 was high (ICC = 0.9, 95% CI = 0.87-0.92, p < 0.001, bias +/- SD = 0.7 +/- 6.1 events/h). Agreement values for OSA diagnosis (77-85%) between devices were similar to those seen from night-to-night variability of OSA using a single device. Awake baseline O2 saturation was significantly higher in the ARESTM (96.2 +/- 1.6%) than WristOx2TM (92.2 +/- 2.1%, p < 0.01). There was a significantly lower %time < 90%O2Sat reported by the ARESTM compared to WristOx2 (median (IQR) 0.5 (0.0, 2.6) vs. 2.1 (0.3, 9.7), p < 0.001), and the correlation was low (ICC = 0.2). CONCLUSIONS: OSA severity metrics predominantly dependent on change in oxygen saturation and metrics used in diagnosis of OSA (AHI4 and ODI) correlated well across devices tested. However, differences in cumulative oxygen desaturation measures (i.e., %time < 90%O2Sat) between the devices suggest that caution is needed when interpreting this metric particularly in populations likely to have significant hypoxia. [Description provided by NIOSH]
• Subjects:
  Aging Occupational Health Respiratory System Safety
• Keywords:
  Age Groups Author Keywords: Limited Channel Monitoring Breathing Equipment Reliability Monitors Obstructive Sleep Apnea Oximetry Oxygen Levels Portable Monitoring Sleep Apnea Sleep Disordered Breathing Testing Equipment

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• ISSN:
  1520-9512
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  139-147
• Volume:
  22
• Issue:
  1
• NIOSHTIC Number:
  nn:20051022
• Citation:
  Sleep Breath 2018 Mar; 22(1):139-147
• Contact Point Address:
  Indu Ayappa, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1232, New York, NY 10029
• Email:
  indu.ayappa@mssm.edu
• CAS Registry Number:
  Oxygen (CAS RN 7782-44-7)
• Federal Fiscal Year:
  2018
• Performing Organization:
  RBHS-Robert Wood Johnson Medical School, Piscataway, New Jersey
• Peer Reviewed:
  True
• Start Date:
  20120901
• Source Full Name:
  Sleep and Breathing
• End Date:
  20170831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c971bfa617bb2a062885cc83de0ef323a062158aadd3017d29cfb81942fb751e53bb3bace5b3f9e511138b6427b845a21b565f0b9ae7141c37b7ab28fa6ee2a5
• Download URL:
  https://stacks.cdc.gov/view/cdc/211162/cdc_211162_DS1.pdf
• File Type:
  [PDF - 915.53 KB ]