CC BY-NC-ND 4.0 · Sleep Sci 2018; 11(04): 269-273
DOI: 10.5935/1984-0063.20180042
ORIGINAL ARTICLE

Quality of an ambulatory monitoring technique for diagnosing obstructive sleep apnea under conditions of limited resources

María del Cármen Hernández-Bendezú
1   National Institute of Respiratory Diseases, Sleep Medicine Unit - Mexico - Mexico City - Mexico.
,
María Yolanda Arias-Peña
1   National Institute of Respiratory Diseases, Sleep Medicine Unit - Mexico - Mexico City - Mexico.
,
Martha Guadalupe Torres-Fraga
1   National Institute of Respiratory Diseases, Sleep Medicine Unit - Mexico - Mexico City - Mexico.
,
José Luis Carrillo-Alduenda
1   National Institute of Respiratory Diseases, Sleep Medicine Unit - Mexico - Mexico City - Mexico.
› Author Affiliations

Objectives: To: 1) evaluate the quality of an ambulatory monitoring technique for diagnosing Obstructive Sleep Apnea Syndrome (OSAS) while patients move through the city; and 2) identify factors that lead to data loss.

Methods: Clinical histories were reviewed and ambulatory portable monitorings of adults with high pretest probability for OSAS were included, the signals monitored were pulse oximetry, heart rate, nasal pressure, snoring, chest band and body position. The equipment was connected from 14:00-20:00 h and then patients moved through the city turning it off and on at home. Results were analyzed visually to record all the minutes lost. A good-quality study was defined as recording time 240 min and signal loss <20%. A cost/benefit analysis was performed using Golpe et al.'s methodology.

Results: A total of 70 recordings were analyzed. Most subjects were obese men with severe OSAS. Signal quality was determined to be good with a median signal loss of 4.9 min (0-405) that represented 1% (0-99) of total recording time. The signal lost most often was pulse oximetry at 1.8 min (0-403,p=0.0001). Of the 70 studies performed, 57 (81%) met the definition of good quality, while 13 (19%) had to be repeated. Men lost the pulse oximetry signal more often than women. This technique could represent savings of 65-75%.

Conclusions: Placing a portable OSAS monitor during the day while patients move around the city turning it on and off at home does not affect the quality of the study results obtained and is a cost-effective method.



Publication History

Received: 09 April 2018

Accepted: 27 September 2018

Article published online:
16 October 2023

© 2023. 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/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 
  • References

  • 1 Bouscoulet LT, Vázquez-García JC, Muiño A, Márquez M, López MV, de Oca MM, et al.; PLATINO Group. Prevalence of sleep related symptoms in four Latin American cities. J Clin Sleep Med. 2008;4(6):579-85.
  • 2 Tarasiuk A, Reuveni H. The economic impact of obstructive sleep apnea. Curr Opin Pulm Med. 2013;19(6):639-44.
  • 3 Pan L, Xie X, Liu D, Ren D, Guo Y. Obstructive sleep apnoea and risks of all-cause mortality: preliminary evidence from prospective cohort studies. Sleep Breath. 2016;20(1):345-53.
  • 4 American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed. Darien: American Academy of Sleep Medicine;2014.
  • 5 Practice parameters for the use of portable recording in the assessment of obstructive sleep apnea. Standards of Practice Committee of the American Sleep Disorders Association. Sleep. 1994;17(4):372-7.
  • 6 Collop NA, Anderson WM, Boehlecke B, Claman D, Goldberg R, Gottlieb DJ, et al.; Portable Monitoring Task Force of the American Academy of Sleep Medicine. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2007;3(7):737-47.
  • 7 Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, et al.; 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. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2012;8(5):597-619.
  • 8 Kapur VK, Rapoport DM, Sanders MH, Enright P, Hill J, Iber C, et al. Rates of sensor loss in unattended home polysomnography: the influence of age, gender, obesity, and sleep-disordered breathing. Sleep. 2000;23(5):682-8.
  • 9 Golpe R, Jiménez A, Carpizo R. Home sleep studies in the assessment of sleep apnea/hypopnea syndrome. Chest. 2002;122(4):1156-61.
  • 10 Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017;13(3):479-504.
  • 11 Campbell AJ, Neill AM. Home set-up polysomnography in the assessment of suspected obstructive sleep apnea. J Sleep Res. 2011;20(1 Pt 2):207-13.
  • 12 Manning JT, Barley L, Walton J, Lewis-Jones DI, Trivers RL, Singh D, et al. The 2nd:4th digit ratio, sexual dimorphism, population differences, and reproductive success. evidence for sexually antagonistic genes? Evol Hum Behav. 2000;21(3):163-83.
  • 13 Kondo T, Zákány J, Innis JW, Duboule D. Of fingers, toes and penises. Nature. 1997;390(6655):29.
  • 14 Kundel V, Shah N. Impact of Portable Sleep Testing. Sleep Med Clin. 2017;12(1):137-47.
  • 15 Kim RD, Kapur VK, Redline-Bruch J, Rueschman M, Auckley DH, Benca RM, et al. An Economic Evaluation of Home Versus Laboratory- Based Diagnosis of Obstructive Sleep Apnea. Sleep. 2015;38(7):1027-37.
  • 16 Santos-Silva R, Sartori DE, Truksinas V, Truksinas E, Alonso FF, Tufik S, et al. Validation of a portable monitoring system for the diagnosis of obstructive sleep apnea syndrome. Sleep. 2009;32(5):629-36.
  • 17 Bruyneel M, Ninane V. Unattended home-based polysomnography for sleep disordered breathing: current concepts and perspectives. Sleep Med Rev. 2014;18(4):341-7.
  • 18 Drager LF. New Challenges for Sleep Apnea Research: Simple Diagnostic Tools, Biomarkers, New Treatments and Precision Medicine. Sleep Sci. 2017;10(1):55-6.