Validation of a Portable Respiratory Monitoring System for the Diagnosis of Obstructive Sleep Apnea in Patients with Chronic Obstructive Pulmonary Disease: A Crossectional Study

Marcus Vinicius F.P. Silva; Thais Clementino Lustosa; Ozeas Lima Lins-Filho; Danielle Cristina Silva Clímaco; Tarcya Couto Patriota; Jessica Amorim Magalhães; Fernando Queiroga Junior; Marilia Montenegro Cabral; Ana Kelley Medeiros; Luiz Oliveira Neto; Valesca Kehrle Rodrigues; Luciano F. Drager; Rodrigo Pinto Pedrosa

doi:10.1055/s-0044-1782530

Sleep Science, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Sleep Sci 2024; 17(03): e221-e226
DOI: 10.1055/s-0044-1782530

Original Research

Validation of a Portable Respiratory Monitoring System for the Diagnosis of Obstructive Sleep Apnea in Patients with Chronic Obstructive Pulmonary Disease: A Crossectional Study

Marcus Vinicius F.P. Silva

¹Sleep and Heart Laboratory, Universidade de Pernambuco, Recife, PE, Brazil

,

Thais Clementino Lustosa

¹Sleep and Heart Laboratory, Universidade de Pernambuco, Recife, PE, Brazil

,

Ozeas Lima Lins-Filho

¹Sleep and Heart Laboratory, Universidade de Pernambuco, Recife, PE, Brazil

,

Danielle Cristina Silva Clímaco

²Otavio de Freitas Hospital, Recife, PE, Brazil

,

Tarcya Couto Patriota

¹Sleep and Heart Laboratory, Universidade de Pernambuco, Recife, PE, Brazil

,

Jessica Amorim Magalhães

¹Sleep and Heart Laboratory, Universidade de Pernambuco, Recife, PE, Brazil

,

Fernando Queiroga Junior

³Osvaldo Cruz Tertiary Hospital, Universidade de Pernambuco, Recife, PE, Brazil

,

Marilia Montenegro Cabral

⁴PROCAPE, Universidade de Pernambuco, Recife, PE, Brazil

,

Ana Kelley Medeiros

¹Sleep and Heart Laboratory, Universidade de Pernambuco, Recife, PE, Brazil

,

Luiz Oliveira Neto

¹Sleep and Heart Laboratory, Universidade de Pernambuco, Recife, PE, Brazil

,

Valesca Kehrle Rodrigues

¹Sleep and Heart Laboratory, Universidade de Pernambuco, Recife, PE, Brazil

,

Luciano F. Drager

⁵Unidade de Hipertensão, Instituto do Coração(InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

,

Rodrigo Pinto Pedrosa

¹Sleep and Heart Laboratory, Universidade de Pernambuco, Recife, PE, Brazil

⁴PROCAPE, Universidade de Pernambuco, Recife, PE, Brazil

› Institutsangaben

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.

Keywords

obstructive sleep apnea - validation studies - sleep breathing disorders

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Referenzen

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
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
3 Isono S. Obesity and obstructive sleep apnoea: mechanisms for increased collapsibility of the passive pharyngeal airway. Respirology 2012; 17 (01) 32-42
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
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
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
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
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
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
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
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;
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
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
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
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
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
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
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
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
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
22 Bittencourt LR, Suchecki D, Tufik S. et al. The variability of the apnoea-hypopnoea index. J Sleep Res 2001; 10 (03) 245-251
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