 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
15 September 1993 | Volume 119 Issue 6 | Pages 449-453
Objective: To evaluate prospectively the validity of home oximetry for case finding in patients clinically suspected of having the sleep apnea hypopnea syndrome (SAHS).
Design: Blinded comparison of home oximetry and polysomnographic nocturnal recordings.
Setting: Sleep clinic of a tertiary referral center.
Patients: A total of 240 outpatients referred because of reported sleep disturbances or daytime hypersomnia compatible with the diagnosis of SAHS.
Measurements: All participants had nocturnal home oximetry followed by a conventional polysomnographic study. The two recordings were interpreted blindly. Home oximetry test results were classified as abnormal (suspicion of sleep-related breathing abnormalities) in the presence of repetitive, short-duration arterial oxyhemoglobin saturation (SaO2) fluctuations without any absolute or relative decrease in the SaO2 threshold. The diagnosis of SAHS was confirmed when the apnea-plus-hypopnea index was greater than 10.
Results: Based on the results of the polysomnographic sleep study, 110 patients had SAHS (apnea-plus-hypopnea index, 38.1 ± 2.5/h; mean ± SE). Home oximetry test results were interpreted as abnormal in 176 patients (this included 108 patients with SAHS and 68 without SAHS) and were read as normal in 62 patients without SAHS and in 2 with SAHS. Home oximetry testing had a sensitivity of 108/110 or 98.2% (95% CI, 93.6% to 99.8%); a specificity of 62/130 or 47.7% (CI, 38.8% to 56.6%); a positive predictive value of 108/176 or 61.4%; and a negative predictive value of 62/64 or 96.9%.
Conclusions: A negative home oximetry test result is helpful in ruling out the diagnosis of SAHS in patients clinically suspected of having this syndrome, because a negative test result reduced the probability from 54.1% to 3.1% in our patients. However, a positive oximetry test increased the probability from 46% to 61.4% in our group of patients.
Author and Article Information
From the Unite de Recherche, Centre de Pneumologie, Hopital Laval, Universite Laval, Quebec, Canada.
ARTICLE
Utility of Nocturnal Home Oximetry for Case Finding in Patients with Suspected Sleep Apnea Hypopnea Syndrome
Requests for Reprints: Frederic Series, MD, Unite de recherche, Centre de Pneumologie, Hopital Laval, 2725 Chemin Sainte Foy, Sainte Foy (Quebec), G1V 4G5 Canada.
Acknowledgments: The authors thank F. Pellegrini, N. Dupuis, J. Beauregard, and A. Veilleux for technical assistance.
Grant Support: In part by The Respiratory Health Network of Centres of Excellence of Canada.
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  D. Hwang, N. Shakir, B. Limann, C. Sison, S. Kalra, L. Shulman, A. d. C. Souza, and H. Greenberg Association of Sleep-Disordered Breathing With Postoperative Complications Chest, May 1, 2008; 133(5): 1128 - 1134. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. T. McNicholas Diagnosis of Obstructive Sleep Apnea in Adults Proceedings of the ATS, February 15, 2008; 5(2): 154 - 160. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V Jobin, P Mayer, and F Bellemare Predictive value of automated oxygen saturation analysis for the diagnosis and treatment of obstructive sleep apnoea in a home-based setting Thorax, May 1, 2007; 62(5): 422 - 427. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Tada, K. F. Kusano, A. Ogawa, J. Iwasaki, S. Sakuragi, I. Kusano, S. Takatsu, M. Miyazaki, and T. Ohe The predictors of central and obstructive sleep apnoea in haemodialysis patients Nephrol. Dial. Transplant., April 1, 2007; 22(4): 1190 - 1197. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. T. Mulgrew, N. Fox, N. T. Ayas, and C. F. Ryan Diagnosis and Initial Management of Obstructive Sleep Apnea without Polysomnography: A Randomized Validation Study Ann Intern Med, February 6, 2007; 146(3): 157 - 166. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Poulain, M. Doucet, G. C. Major, V. Drapeau, F. Series, L.-P. Boulet, A. Tremblay, and F. Maltais The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies. Can. Med. Assoc. J., April 25, 2006; 174(9): 1293 - 1299. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Series, R. J. Kimoff, D. Morrison, M. H. Leblanc, M. Smilovitch, J. Howlett, A. G. Logan, J. S. Floras, and T. D. Bradley Prospective Evaluation of Nocturnal Oximetry for Detection of Sleep-Related Breathing Disturbances in Patients With Chronic Heart Failure Chest, May 1, 2005; 127(5): 1507 - 1514. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y Lacasse, M-P Bureau, and F Series A new standardised and self-administered quality of life questionnaire specific to obstructive sleep apnoea Thorax, June 1, 2004; 59(6): 494 - 499. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Roche, V. Pichot, E. Sforza, I. Court-Fortune, D. Duverney, F. Costes, M. Garet, and J-C. Barthelemy Predicting sleep apnoea syndrome from heart period: a time-frequency wavelet analysis Eur. Respir. J., December 1, 2003; 22(6): 937 - 942. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. E. Bloch Getting the Most Out of Nocturnal Pulse Oximetry Chest, November 1, 2003; 124(5): 1628 - 1630. [Full Text] [PDF]
|
|
|
|
|
|
W. W. Flemons, M. R. Littner, J. A. Rowley, P. Gay, W. M. Anderson, D. W. Hudgel, R. D. McEvoy, and D. I. Loube Home Diagnosis of Sleep Apnea: A Systematic Review of the Literature: An Evidence Review Cosponsored by the American Academy of Sleep Medicine, the American College of Chest Physicians, and the American Thoracic Society Chest, October 1, 2003; 124(4): 1543 - 1579. [Full Text] [PDF]
|
|
|
|
|
|
D. D. Sin Sleep-Disordered Breathing: A Heart-Changing Experience? Chest, September 1, 2003; 124(3): 778 - 780. [Full Text] [PDF]
|
|
|
|
|
|
C. Zamarron, F. Gude, J. Barcala, J. R. Rodriguez, and P. V. Romero Utility of Oxygen Saturation and Heart Rate Spectral Analysis Obtained From Pulse Oximetric Recordings in the Diagnosis of Sleep Apnea Syndrome Chest, May 1, 2003; 123(5): 1567 - 1576. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. G. Davila, K. C. Richards, B. L. Marshall, P. S. O'Sullivan, T. G. Gregory, V. J. Hernandez, and S. I. Rice Oximeter Performance: The Influence of Acquisition Parameters Chest, November 1, 2002; 122(5): 1654 - 1660. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. W. Flemons Obstructive Sleep Apnea N. Engl. J. Med., August 15, 2002; 347(7): 498 - 504. [Full Text] [PDF]
|
|
|
|
|
|
Y. Lacasse, C. Godbout, and F. Series Health-related quality of life in obstructive sleep apnoea Eur. Respir. J., March 1, 2002; 19(3): 499 - 503. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Roche, B. Herer, C. Roig, and G. Huchon Prospective Testing of Two Models Based on Clinical and Oximetric Variables for Prediction of Obstructive Sleep Apnea Chest, March 1, 2002; 121(3): 747 - 752. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Zoccali, F. Mallamaci, and G. Tripepi Nocturnal Hypoxemia Predicts Incident Cardiovascular Complications in Dialysis Patients J. Am. Soc. Nephrol., March 1, 2002; 13(3): 729 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Series, N. Netzer, and Col. A. Eliasson Interpretation of Home Oximetry Tracings Chest, March 1, 2002; 121(3): 1006 - 1007. [Full Text] [PDF]
|
|
|
|
|
|
C. Zoccali, F. Mallamaci, and G. Tripepi Sleep Apnea in Renal Patients J. Am. Soc. Nephrol., December 1, 2001; 12(12): 2854 - 2859. [Full Text] [PDF]
|
|
|
|
 |
|
 I. GURUBHAGAVATULA, G. MAISLIN, and A. I. PACK An Algorithm to Stratify Sleep Apnea Risk in a Sleep Disorders Clinic Population Am. J. Respir. Crit. Care Med., November 15, 2001; 164(10): 1904 - 1909. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Wiltshire, A. H. Kendrick, and J. R. Catterall Home Oximetry Studies for Diagnosis of Sleep Apnea/Hypopnea Syndrome : Limitation of Memory Storage Capabilities Chest, August 1, 2001; 120(2): 384 - 389. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Zoccali, F. Mallamaci, G. Tripepi, and F. A. Benedetto Autonomic neuropathy is linked to nocturnal hypoxaemia and to concentric hypertrophy and remodelling in dialysis patients Nephrol. Dial. Transplant., January 1, 2001; 16(1): 70 - 77. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Zoccali Sleep apnoea and nocturnal hypoxaemia in dialysis patients: mere risk-indicators or causal factors for cardiovascular disease? Nephrol. Dial. Transplant., December 1, 2000; 15(12): 1919 - 1921. [Full Text] [PDF]
|
|
|
|
|
|
M P Bureau and F Sériès Comparison of two in-laboratory titration methods to determine effective pressure levels in patients with obstructive sleep apnoea Thorax, September 1, 2000; 55(9): 741 - 745. [Abstract] [Full Text]
|
|
|
|
|
|
J.-C. Vázquez, W. H Tsai, W W. Flemons, A. Masuda, R. Brant, E. Hajduk, W. A Whitelaw, and J. E Remmers Automated analysis of digital oximetry in the diagnosis of obstructive sleep apnoea Thorax, April 1, 2000; 55(4): 302 - 307. [Abstract] [Full Text]
|
|
|
|
 |
|
 R. T. Brouillette, A. Morielli, A. Leimanis, K. A. Waters, R. Luciano, and F. M. Ducharme Nocturnal Pulse Oximetry as an Abbreviated Testing Modality for Pediatric Obstructive Sleep Apnea Pediatrics, February 1, 2000; 105(2): 405 - 412. [Abstract] [Full Text]
|
|
|
|
|
|
F Sériès, J L. Forge, N Lampron, and Y Cormier Transtracheal air in the treatment of obstructive sleep apnoea hypopnoea syndrome Thorax, January 1, 2000; 55(1): 86 - 87. [Abstract] [Full Text]
|
|
|
|
|
|
J A BENNETT and W J M KINNEAR Sleep on the cheap: the role of overnight oximetry in the diagnosis of sleep apnoea hypopnoea syndrome Thorax, November 1, 1999; 54(11): 958 - 959. [Full Text]
|
|
|
|
|
|
E. Chiner, J. Signes-Costa, J. M. Arriero, J. Marco, I. Fuentes, and A. Sergado Nocturnal oximetry for the diagnosis of the sleep apnoea hypopnoea syndrome: a method to reduce the number of polysomnographies? Thorax, November 1, 1999; 54(11): 968 - 971. [Abstract] [Full Text]
|
|
|
|
|
|
S. D. Kirby, P Eng, W. Danter, C. F. P. George, T. Francovic, R. R. F. Ruby, and K. A. Ferguson Neural Network Prediction of Obstructive Sleep Apnea From Clinical Criteria Chest, August 1, 1999; 116(2): 409 - 415. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. P. Lonergan III, J. C. Ware, R. L. Atkinson, W. C. Winter, and P. M. Suratt Sleep apnea in obese miniature pigs J Appl Physiol, February 1, 1998; 84(2): 531 - 536. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. C. Good, J. Q. Henkle, D. Gelber, J. Welsh, and S. Verhulst Sleep-Disordered Breathing and Poor Functional Outcome After Stroke Stroke, February 1, 1996; 27(2): 252 - 259. [Abstract] [Full Text]
|
|
|
|
 |
|
 A K Simonds Sleep studies of respiratory function and home respiratory support BMJ, July 2, 1994; 309(6946): 35 - 40. [Full Text]
|
|
|
|
 |
|
 HOME OXIMETRY SCREENING FOR SLEEP APNEA Journal Watch (General), October 5, 1993; 1993(1005): 2 - 2. [Full Text]
|
|
Article
