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CC BY-NC-ND 4.0 · Sleep Sci 2019; 12(04): 249-256
DOI: 10.5935/1984-0063.20190089
ORIGINAL ARTICLE

CPAP indication based on clinical data and oximetry for patients with suspicion of obstructive sleep apnea: A multicenter trial

Autor*innen

  • Carlos Alberto Nigro

    1   Hospital Alemán, Sleep Lab, Pneumonology - Buenos Aires - Buenos Aires - Argentina.

  • Eduardo Enrique Borsini

    2   Hospital Británico, Sleep Lab, Pneumonology - Buenos Aires - Buenos Aires - Argentina.

  • Eduardo Dibur

    1   Hospital Alemán, Sleep Lab, Pneumonology - Buenos Aires - Buenos Aires - Argentina.

  • Luis Dario Larrateguy

    3   Centro Privado de Medicina Respiratoria, Sleep Lab, Pneumonology - Paraná - Entre Rios - Argentina.

  • Alexis Cazaux

    4   Centro Dr. Lázaro Langer, Sleep Lab, Pneumonology - Córdoba - Córdoba - Argentina.

  • Carlos Elias

    5   Instituto Médico Insares, Sleep Lab, Pneumonology - Mendoza - Mendoza - Argentina.

  • Marcelino de-la-Vega

    6   Hospital Privado Santa Clara de Asis, Sleep Lab, Pneumonology - Salta - Salta - Argentina.

  • Cecilia Berrozpe

    7   FLENI, Sleep Lab, Neurology - Buenos Aires - Buenos Aires - Argentina.

  • Silvana Maggi

    8   CEMIC, Sleep Lab, Neurology - Buenos Aires - Buenos Aires - Argentina.

  • Sofía Grandval

    9   Sanatorio San Lucas, Sleep Lab, Pneumonology - San Isidro - Buenos Aires - Argentina.

  • Hugo Cambursano

    4   Centro Dr. Lázaro Langer, Sleep Lab, Pneumonology - Córdoba - Córdoba - Argentina.

  • Daniela Visentini

    10   Hospital Cetrángolo, Sleep lab, Pneumonology - Florida - Buenos Aires - Argentina.

  • Juan Criniti

    1   Hospital Alemán, Sleep Lab, Pneumonology - Buenos Aires - Buenos Aires - Argentina.

  • Facundo Nogueira

    1   Hospital Alemán, Sleep Lab, Pneumonology - Buenos Aires - Buenos Aires - Argentina.
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Background and Objective: The usefulness of pulse oximetry for the management of obstructive sleep apnea is controversial. The aim of this study was to assess the accuracy for indication of Continuous Positive Airway Pressure (CPAP) treatment in patients with suspected obstructive sleep apnea (OSA) based on clinical and oximetry data as compared to polysomnography (PSG).

Methods: This multicenter observational study involved seven sleep laboratories. Patients with suspicion of OSA who completed a standardized sleep questionnaire and a diagnostic PSG were enrolled. Eight observers logged on to a website independently and blindly. Seven observers only accessed the clinical data, curve and pulse oximetry results (Os-SO2-test method), while the eighth observer had full access to all indicators of PSG (O-PSG-reference method). Once observers assessed the information available on the website, they had to choose between three CPAP treatment options (yes/no/do not know) based on their knowledge and criteria.

Results: 411 subjects (228 men), median age 54 years, were available for evaluation. Os-SO2 had lower sensitivity (S), greater specificity (Sp) and positive likelihood ratio (PLR) to prescribe CPAP in patients more symptomatic (Epworth Sleepiness Scale-ESS > 10 or comorbidities) than those with fewer symptoms (ESS < 11 without comorbidities) (S 45-75% versus 45-91%,p 0.028); Sp 93.8-100% versus 68.5-96.6%,p 0.004; PLR > 10 versus 2.9-17,p<0.01).

Conclusions: Due to its low false positive rate, a strategy based on pulse oximetry and clinical data was a consistent tool to indicate CPAP treatment in most symptomatic patients with a suspicion of OSA.

Continuous Positive Airway Pressure - Diagnosis - Oximetry - Obstructive Sleep Apnea - Ambulatory Monitoring

Funding:

No funding was received for this research.


Ethical approval:

All procedures performed in studies involving human participants were in accordance with the ethical standards of our institutional committee and with the 1964 Helsinki declaration and its later amendments.


APPENDIX I



Publikationsverlauf

Eingereicht: 27. April 2019

Angenommen: 18. September 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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