Detecting central sleep apnea in adult patients using WatchPAT-a multicenter validation study.

Autor: Pillar G; Technion Faculty of Medicine, Sleep Laboratory, Carmel Medical Center, Haifa, Israel. gpillar@technion.ac.il., Berall M; Center of Sleep and Chronobiology, Toronto, ON, Canada., Berry R; Health Sleep center, University of Florida, Gainesville, FL, USA., Etzioni T; Technion Faculty of Medicine, Sleep Laboratory, Carmel Medical Center, Haifa, Israel., Shrater N; Cardiology Department, Soroka Medical Center, Be'er Sheva, Israel., Hwang D; Kaiser Permanente Fontana Medical Center, Fontana, CA, USA., Ibrahim M; Cardiology Department, Rambam Medical Center, Haifa, Israel., Litman E; Itamar Medical, Caesarea, Israel., Manthena P; Sleep clinic, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA., Koren-Morag N; Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel., Rama A; Kaiser Permanente San Jose Medical Center, San Jose, CA, USA., Schnall RP; Itamar Medical, Caesarea, Israel., Sheffy K; Itamar Medical, Caesarea, Israel., Spiegel R; Stony Brook University Hospital, Stony Brook, NY, USA., Tauman R; Sleep Disorders Center, Tel Aviv Souraski Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Penzel T; Charite Universitätsmedizin Berlin, Berlin, Germany.
Jazyk: angličtina
Zdroj: Sleep & breathing = Schlaf & Atmung [Sleep Breath] 2020 Mar; Vol. 24 (1), pp. 387-398. Date of Electronic Publication: 2019 Aug 11.
DOI: 10.1007/s11325-019-01904-5
Abstrakt: Study Objectives: To assess the accuracy of WatchPAT (WP-Itamar-Medical, Caesarea, Israel) enhanced with a novel systolic upstroke analysis coupled with respiratory movement analysis derived from a dedicated snoring and body position (SBP) sensor, to enable automated algorithmic differentiation between central sleep apnea (CSA) and obstructive sleep apnea (OSA) compared with simultaneous in-lab sleep studies with polysomnography (PSG).
Methods: Eighty-four patients with suspected sleep-disordered breathing (SDB) underwent simultaneous WP and PSG studies in 11 sleep centers. PSG scoring was blinded to the automatically analyzed WP data.
Results: Overall WP apnea-hypopnea index (AHI; mean ± SD) was 25.2 ± 21.3 (range 0.2-101) versus PSG AHI 24.4 ± 21.2 (range 0-110) (p = 0.514), and correlation was 0.87 (p < 0.001). Using a threshold of AHI ≥ 15, the sensitivity and specificity of WP versus PSG for diagnosing sleep apnea were 85% and 70% respectively and agreement was 79% (kappa = 0.867). WP central AHI (AHIc) was 4.2 ± 7.7 (range 0-38) versus PSG AHIc 5.9 ± 11.8 (range 0-63) (p = 0.034), while correlation was 0.90 (p < 0.001). Using a threshold of AHI ≥ 15, the sensitivity and specificity of WP versus PSG for diagnosing CSA were 67% and 100% respectively with agreement of 95% (kappa = 0.774), and receiver operator characteristic (ROC) area under the curve of 0.866, (p < 0.01). Using a threshold of AHI ≥ 10 showed comparable overall sleep apnea and CSA diagnostic accuracies.
Conclusions: These findings show that WP can accurately detect overall AHI and effectively differentiate between CSA and OSA.
Databáze: MEDLINE
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