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CC BY-NC-ND 4.0 · Sleep Sci 2019; 12(02): 65-71
DOI: 10.5935/1984-0063.20190072
ORIGINAL ARTICLE

Pragmatic Validation of Home Portable Sleep Monitor for diagnosing Obstructive Sleep Apnea in a non-referred population: The ELSA-Brasil study

Aline N. Aielo
1   University of Sao Paulo, Center of Clinical and Epidemiologic Research (CPCE) - São Paulo - São Paulo - Brazil.
2   University of Sao Paulo, Hypertension Unit, Renal Division - São Paulo - São Paulo - Brazil.
,
Ronaldo B. Santos
1   University of Sao Paulo, Center of Clinical and Epidemiologic Research (CPCE) - São Paulo - São Paulo - Brazil.
3   University of Sao Paulo, Hypertension Unit, Heart Institute (InCor) - São Paulo - São Paulo - Brazil.
,
Wagner A. Silva
1   University of Sao Paulo, Center of Clinical and Epidemiologic Research (CPCE) - São Paulo - São Paulo - Brazil.
3   University of Sao Paulo, Hypertension Unit, Heart Institute (InCor) - São Paulo - São Paulo - Brazil.
,
Barbara K. Parise
1   University of Sao Paulo, Center of Clinical and Epidemiologic Research (CPCE) - São Paulo - São Paulo - Brazil.
2   University of Sao Paulo, Hypertension Unit, Renal Division - São Paulo - São Paulo - Brazil.
,
Silvana P. Souza
1   University of Sao Paulo, Center of Clinical and Epidemiologic Research (CPCE) - São Paulo - São Paulo - Brazil.
3   University of Sao Paulo, Hypertension Unit, Heart Institute (InCor) - São Paulo - São Paulo - Brazil.
,
Lorenna F. Cunha
1   University of Sao Paulo, Center of Clinical and Epidemiologic Research (CPCE) - São Paulo - São Paulo - Brazil.
,
Soraya Giatti
1   University of Sao Paulo, Center of Clinical and Epidemiologic Research (CPCE) - São Paulo - São Paulo - Brazil.
2   University of Sao Paulo, Hypertension Unit, Renal Division - São Paulo - São Paulo - Brazil.
,
Paulo A. Lotufo
1   University of Sao Paulo, Center of Clinical and Epidemiologic Research (CPCE) - São Paulo - São Paulo - Brazil.
,
Isabela M. Bensenor
1   University of Sao Paulo, Center of Clinical and Epidemiologic Research (CPCE) - São Paulo - São Paulo - Brazil.
,
Luciano F. Drager
1   University of Sao Paulo, Center of Clinical and Epidemiologic Research (CPCE) - São Paulo - São Paulo - Brazil.
2   University of Sao Paulo, Hypertension Unit, Renal Division - São Paulo - São Paulo - Brazil.
3   University of Sao Paulo, Hypertension Unit, Heart Institute (InCor) - São Paulo - São Paulo - Brazil.
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Objective Polygraphy (PG) is an attractive alternative for diagnosing obstructive sleep apnea (OSA) in patients with high pre-test probability. However, several patients may not present typical symptoms. In this scenario, it is unclear the performance of PG for diagnosing OSA in non-referred populations to sleep laboratories.

Methods Data from participants of the ELSA-Brasil cohort were used for this analysis. We performed an overnight home PG (Embletta GoldTM) synchronized with a wrist actigraphy (Actiwatch model 2TM). The validation strategy comprised three scorings from each participant: 1) Original scoring (PG): Routine scoring using data from the exclamation button mark to define “analysis start” and “analysis stop”; 2) Scoring using actigraphy data (PG+actigraphy): total sleep time defined by the actigraphy data; 3) Scoring using diaries (PG+diary): “analysis start” and “analysis stop” based on the diaries. Bland-Altman plots were generated to assess the agreements (Kappa) between each scoring strategy.

Results A total of 300 participants were included in the final analysis (45% males, mean age: 48±8 years). The frequency of OSA using the PG score was 27.3%. Despite small differences in the OSA severity index, we obtained a high concordance of AHI comparing the PG vs. PG+actigraphy (Kappa: 0.95) as well as PG+diary vs. PG+actigraphy (Kappa: 0.96). No significant changes in the OSA classification (mild, moderate and severe) were observed in the 3 protocols.

Conclusion Using a pragmatic approach to address OSA at home, our results suggest that PG is a useful tool for OSA diagnosis even in subjects not referred to sleep studies.

Sleep Apnea - Diagnosis - Polysomnography - Wrist


Publikationsverlauf

Eingereicht: 27. März 2019

Angenommen: 09. Mai 2019

Artikel online veröffentlicht:
31. Oktober 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/)

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