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DOI: 10.1055/s-0044-1782530
Validation of a Portable Respiratory Monitoring System for the Diagnosis of Obstructive Sleep Apnea in Patients with Chronic Obstructive Pulmonary Disease: A Crossectional Study
Funding Source This work was supported by a grant (grant 1783-4.01/2016) from the Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco (FACEPE).
Abstract
Introduction Portable respiratory monitoring (PM) has been used to diagnose obstructive sleep apnea (OSA) in the general population. However, its validation in patients with both OSA and chronic obstructive pulmonary disease (COPD), remains unclear.
Objective The aim of the study was to validate PM for the diagnosis of OSA in patients with COPD.
Materials and Methods In this crossectional study, COPD patients were submitted simultaneously to polysomnography (PSG) and PM. Moreover, the risk for OSA was verified by the Berlin, NoSAS, and STOP-BANG questionnaires. Sensitivity, specificity, positive predictive value, and negative predictive value for PM were calculated for the cutoff points of the hypopnea apnea index (AHI) of 5, 15, and 30 events/hour, as well as for the questionnaires. The Bland-Altman test and correlation analyses between the AHI of the PSG and PM were performed.
Results A total of 103 patients were evaluated (age 67.5 ± 9.9 years, 60% men). The STOP-BANG questionnaire had the highest sensitivity for OSA diagnosis, at 94.4% (72.7–99.9%). The sensitivity of PM decreased (87.0, 66.7, and 44.4%), and the specificity increased 40.0, 78.6, and 100.0%) as the AHI cutoff point increased from 5, 15, and 30. The Bland-Altman test indicated good limits of agreement (AHI = 5.5 ± 11.7 events/hour). Therefore, the AHI results of the PM showed a strong and positive correlation with those of the PSG (r = 0.70, p < 0.0001).
Conclusion The PM test can be a useful tool for OSA diagnosis in patients with COPD.
Publication History
Received: 10 April 2023
Accepted: 11 September 2023
Article published online:
29 May 2024
© 2024. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Tufik S, Santos-Silva R, Taddei JA, Bittencourt LR. Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med 2010; 11 (05) 441-446 DOI: 10.1016/j.sleep.2009.10.005.
- 2 Heinzer R, Vat S, Marques-Vidal P. et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 2015; 3 (04) 310-318 DOI: 10.1016/S2213-2600(15)00043-0.
- 3 Isono S. Obesity and obstructive sleep apnoea: mechanisms for increased collapsibility of the passive pharyngeal airway. Respirology 2012; 17 (01) 32-42 DOI: 10.1111/j.1440-1843.2011.02093.x.
- 4 Soler X, Gaio E, Powell FL. et al. High Prevalence of Obstructive Sleep Apnea in Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 2015; 12 (08) 1219-1225 DOI: 10.1513/AnnalsATS.201407-336OC.
- 5 Trask CH, Cree EM. Oximeter studies on patients with chronic obstructive emphysema, awake and during sleep. N Engl J Med 1962; 266: 639-642 DOI: 10.1056/NEJM196203292661303.
- 6 Pierce AK, Jarrett CE, Werkle Jr G, Miller WF. Respiratory function during sleep in patients with chronic obstructive lung disease. J Clin Invest 1966; 45 (05) 631-636 DOI: 10.1172/JCI105378.
- 7 Aurora RN, Collop NA, Jacobowitz O. et al. Quality measures for the care of adult patients with obstructive sleep apnea. J Clin Sleep Med 2015; 11 (03) 357-383 DOI: 10.5664/jcsm.4556.
- 8 Somers VK, White DP, Amin R. et al. Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. J Am Coll Cardiol 2008; 52 (08) 686-717 DOI: 10.1016/j.jacc.2008.05.002.
- 9 Santos-Silva R, Sartori DE, Truksinas V. et al. Validation of a portable monitoring system for the diagnosis of obstructive sleep apnea syndrome. Sleep 2009; 32 (05) 629-636 DOI: 10.1093/sleep/32.5.629.
- 10 Aurora RN, Patil SP, Punjabi NM. Portable Sleep Monitoring for Diagnosing Sleep Apnea in Hospitalized Patients With Heart Failure. Chest 2018; 154 (01) 91-98 DOI: 10.1016/j.chest.2018.04.008.
- 11 Fredheim JM, Røislien J, Hjelmesæth J. Validation of a portable monitor for the diagnosis of obstructive sleep apnea in morbidly obese patients. J Clin Sleep Med 2014; 10 (07) 751-757, 757A . PMC4067438; DOI: 10.5664/jcsm.3864.
- 12 Chang Y, Xu L, Han F. et al. Validation of the Nox-T3 Portable Monitor for Diagnosis of Obstructive Sleep Apnea in Patients With Chronic Obstructive Pulmonary Disease. J Clin Sleep Med 2019; 15 (04) 587-596 DOI: 10.5664/jcsm.7720.
- 13 Berry RB, Budhiraja R, Gottlieb DJ. et al; American Academy of Sleep Medicine, Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. J Clin Sleep Med 2012; 8 (05) 597-619 DOI: 10.5664/jcsm.2172.
- 14 Khaledi-Paveh B, Khazaie H, Nasouri M. et al. Evaluation of Berlin Questionnaire Validity for Sleep Apnea Risk in Sleep Clinic Populations. Basic Clin Neurosci 2016; 7 (01) 43-48
- 15 Duarte RLM, Fonseca LBM, Magalhães-da-Silveira FJ. et al. Validation of the STOP-Bang questionnaire as a means of screening for obstructive sleep apnea in adults in Brazil. J Bras Pneumol 2017; 43 (06) 456-463 DOI: 10.1590/S1806-37562017000000139.
- 16 Giampá SQC, Pedrosa RP, Gonzaga CC. et al. Performance of NoSAS score versus Berlin questionnaire for screening obstructive sleep apnoea in patients with resistant hypertension. J Hum Hypertens 2018; 32 (07) 518-523 DOI: 10.1038/s41371-018-0072-z.
- 17 Polese JF, Santos-Silva R, de Oliveira Ferrari PM. et al. Is portable monitoring for diagnosing obstructive sleep apnea syndrome suitable in elderly population?. Sleep Breath 2013; 17 (02) 679-686 DOI: 10.1007/s11325-012-0742-y.
- 18 Quintana-Gallego E, Villa-Gil M, Carmona-Bernal C. et al. Home respiratory polygraphy for diagnosis of sleep-disordered breathing in heart failure. Eur Respir J 2004; 24 (03) 443-448 DOI: 10.1183/09031936.04.00140603.
- 19 Oliveira MG, Nery LE, Santos-Silva R. et al. Is portable monitoring accurate in the diagnosis of obstructive sleep apnea syndrome in chronic pulmonary obstructive disease?. Sleep Med 2012; 13 (08) 1033-1038 DOI: 10.1016/j.sleep.2012.06.011.
- 20 Pedrosa RP, Drager LF, Genta PR. et al. Obstructive sleep apnea is common and independently associated with atrial fibrillation in patients with hypertrophic cardiomyopathy. Chest 2010; 137 (05) 1078-1084 DOI: 10.1378/chest.09-2335.
- 21 Stöberl AS, Schwarz EI, Haile SR. et al. Night-to-night variability of obstructive sleep apnea. J Sleep Res 2017; 26 (06) 782-788 DOI: 10.1111/jsr.12558.
- 22 Bittencourt LR, Suchecki D, Tufik S. et al. The variability of the apnoea-hypopnoea index. J Sleep Res 2001; 10 (03) 245-251 DOI: 10.1046/j.1365-2869.2001.00255.x.
- 23 Mjid M, Ouahchi Y, Toujani S. et al. [Night-to-night variability of the obstructive sleep apnoea-hypopnoea syndrome]. Rev Mal Respir 2016; 33 (09) 775-780 DOI: 10.1016/j.rmr.2016.04.023.