LETTER
Nocturnal Home Oximetry in Detecting the Sleep Apnea-Hypopnea Syndrome and in Working Up Hypersomnolence
Neil T. Feldman, MD, and
Harpreet Singh, MD
1 March 1994 | Volume 120 Issue 5 | Pages 439-440
TO THE EDITOR:
Series and colleagues [1] concluded that nocturnal home oximetry screening in patients suspected to have the obstructive sleep apnea-hypopnea syndrome would decrease the number of patients who required complete polysomnographic monitoring. They suggested, however, that because of its low specificity and consequent low positive predictive value, positive home oximetry must be followed by complete polysomnographic monitoring. They studied 240 outpatients referred because of reported sleep disturbances or daytime hypersomnia and confirmed the syndrome in 110. The diagnosis and follow-up of the remaining 130 patients were not defined by the study.
Patients not found to have the syndrome represent an equally important group. Daytime sleepiness, even in the absence of sleep apnea, is not a trivial complaint. Narcolepsy, idiopathic central nervous system hypersomnia, periodic leg movement disorder, and the insufficient sleep syndrome are significant disorders that may also occur in individuals with concomitant snoring. Nocturnal polysomnography with multiple sleep latency testing is necessary in these patients to establish a diagnosis.
In our opinion, nocturnal polysomnography and multiple sleep latency testing are still indicated, even if the screening test result is negative. Thus, screening nocturnal oximetry can only add to the expense of the clinical evaluation.
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Author and Article Information
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St. Petersburg Sleep Disorders Center; St. Petersburg, FL 33707
1. Series F, Marc I, Cormier Y, LaForge J. Utility of nocturnal home oximetry for case finding in patients with suspected sleep apnea hypopnea syndrome. Ann Intern Med. 1993; 119:449-53.
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