Significance of Including a Surrogate Arousal for Sleep Apnea-Hypopnea Syndrome Diagnosis by Respiratory Polygraphy
| Autor: | Felipe Aizpuru, Alberto Alonso, R. Cano, Juan F. Masa, Carmen Monasterio, Neus Salord, Marta Cabello, Garcia-Ledesma E, Ricardo Mendes Pereira, Miguel Carrera, Laura Cancelo, Eusebi Chiner, Gomez de Terreros J, Luis Hernández-Blasco, José N. Sancho-Chust, Jaime Corral, Lirios Sacristan, José Luis Zamorano, Jose M. Montserrat, Martinez A, Cristina Embid, Joaquín Durán-Cantolla |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Adolescent Polysomnography medicine.medical_treatment Arousal Young Adult Sleep Apnea Syndromes Physiology (medical) mental disorders medicine Humans Continuous positive airway pressure Aged Monitoring Physiologic Cross-Over Studies Receiver operating characteristic medicine.diagnostic_test business.industry Apnea Sleep apnea Syndrome Middle Aged medicine.disease Surrogate Arousal for Sleep Apnea-Hypopnea Syndrome Diagnosis nervous system diseases respiratory tract diseases Obstructive sleep apnea Anesthesia Respiratory Physiological Phenomena Female Neurology (clinical) medicine.symptom business Hypopnea psychological phenomena and processes |
| Zdroj: | Sleep. 36:249-257 |
| ISSN: | 1550-9109 0161-8105 |
| DOI: | 10.5665/sleep.2384 |
| Popis: | RATIONALE Respiratory polygraphy is an accepted alternative to polysomnography (PSG) for sleep apnea/hypopnea syndrome (SAHS) diagnosis, although it underestimates the apnea-hypopnea index (AHI) because respiratory polygraphy cannot identify arousals. OBJECTIVES We performed a multicentric, randomized, blinded crossover study to determine the agreement between home respiratory polygraphy (HRP) and PSG, and between simultaneous respiratory polygraphy (respiratory polygraphy with PSG) (SimultRP) and PSG by means of 2 AHI scoring protocols with or without hyperventilation following flow reduction considered as a surrogate arousal. METHODS We included suspected SAHS patients from 8 hospitals. They were assigned to home and hospital protocols at random. We determined the agreement between respiratory polygraphy AHI and PSG AHI scorings using Bland and Altman plots and diagnostic agreement using receiver operating characteristic (ROC) curves. The agreement in therapeutic decisions (continuous positive airway pressure treatment or not) between HRP and PSG scorings was done with likelihood ratios and post-test probability calculations. RESULTS Of 366 randomized patients, 342 completed the protocol. AHI from HRP scorings (with and without surrogate arousal) had similar agreement with PSG. AHI from SimultRP with surrogate arousal scoring had better agreement with PSG than AHI from SimultRP without surrogate arousal. HRP with surrogate arousal scoring had slightly worse ROC curves than HRP without surrogate arousal, and the opposite was true for SimultRP scorings. HRP with surrogate arousal showed slightly better agreement with PSG in therapeutic decisions than for HRP without surrogate arousal. CONCLUSION Incorporating a surrogate arousal measure into HRP did not substantially increase its agreement with PSG when compared with the usual procedure (HRP without surrogate arousal). |
| Databáze: | OpenAIRE |
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