Phenotyping REM OSA by means of peripheral arterial tone‐based home sleep apnea testing and polysomnography: A critical assessment of the sensitivity and specificity of both methods

2021 ◽  
Author(s):  
Frederik Massie ◽  
Bart Van Pee ◽  
Steven Vits ◽  
Johan Verbraecken ◽  
Jeroen Bergmann
Keyword(s):  
Sleep Apnea ◽  
Sensitivity And Specificity ◽  
Critical Assessment ◽  
Home Sleep Apnea Testing ◽  
Peripheral Arterial ◽  
Arterial Tone ◽  
Apnea Testing

scholarly journals The design of RIP belts impacts the reliability and quality of the measured respiratory signals

2021 ◽  
Author(s):  
Kristofer Montazeri ◽  
Sigurdur Aegir Jonsson ◽  
Jon Skirnir Agustsson ◽  
Marta Serwatko ◽  
Thorarinn Gislason ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Sleep Apnea ◽  
Automatic Assessment ◽  
Signal Reliability ◽  
Respiratory Airflow ◽  
Flow Quality ◽  
The Mean ◽  
Home Sleep Apnea Testing ◽  
Apnea Testing

Abstract Purpose Evaluate the effect of respiratory inductance plethysmography (RIP) belt design on the reliability and quality of respiratory signals. A comparison of cannula flow to disposable cut-to-fit, semi-disposable folding and disposable RIP belts was performed in clinical home sleep apnea testing (HSAT) studies. Methods This was a retrospective study using clinical HSAT studies. The signal reliability of cannula, thorax, and abdomen RIP belts was determined by automatically identifying periods during which the signals did not represent respiratory airflow and breathing movements. Results were verified by manual scoring. RIP flow quality was determined by examining the correlation between the RIP flow and cannula flow when both signals were considered reliable. Results Of 767 clinical HSAT studies, mean signal reliability of the cut-to-fit, semi-disposable, and disposable thorax RIP belts was 83.0 ± 26.2%, 76.1 ± 24.4%, and 98.5 ± 9.3%, respectively. The signal reliability of the cannula was 92.5 ± 16.1%, 87.0 ± 23.3%, and 85.5 ± 24.5%, respectively. The automatic assessment of signal reliability for the RIP belts and cannula flow had a sensitivity of 50% and a specificity of 99% compared with manual assessment. The mean correlation of cannula flow to RIP flow from the cut-to-fit, semi-disposable, and disposable RIP belts was 0.79 ± 0.24, 0.52 ± 0.20, and 0.86 ± 0.18, respectively. Conclusion The design of RIP belts affects the reliability and quality of respiratory signals. The disposable RIP belts that had integrated contacts and did not fold on top of themselves performed the best. The cut-to-fit RIP belts were most likely to be unreliable, and the semi-disposable folding belts produced the lowest-quality RIP flow signals compared to the cannula flow signal.

424 Advanced gestational age is a predictor of non-completion of sleep apnea testing in pregnancy

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A168-A168
Author(s):  
Mihaela Bazalakova ◽  
Abigail Wiedmer ◽  
Lauren Rice ◽  
Sakshi Bajaj ◽  
Natalie Jacobson ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Gestational Age ◽  
Retrospective Chart Review ◽  
Pregnant Patient ◽  
Clinic Visit ◽  
Early Screening ◽  
Home Sleep Apnea Testing ◽  
Living Children ◽  
Apnea Testing ◽  
In Pregnancy

Abstract Introduction Sleep apnea is emerging as an important and underdiagnosed comorbidity in pregnancy. Screening, diagnosis, and initiation of therapy are all time-sensitive processes during the dynamic progression of gestation. Completion of referral and testing for sleep apnea during pregnancy requires a significant commitment of time and effort on the part of the pregnant patient. We evaluated for predictors of non-completion of sleep apnea testing within our obstetric-sleep referral pipeline, in an effort to inform and optimize future referrals. Methods We performed a retrospective chart-review of 405 pregnant patient referrals for sleep apnea evaluation at the University of Wisconsin-Madison/UnityPoint sleep apnea pregnancy clinic. We used logistic regression analysis to determine predictors of lack of completion of sleep apnea testing. Results The vast majority of referrals (>95%) were triaged directly to home sleep apnea testing with the Alice PDX portable device, rather than a sleep clinic visit. The overall rate of referral non-completion was 59%. Predictors of non-completion of sleep apnea evaluation in our pregnant population included higher gestational age (GA) at referral (1–12 wks GA: 30%, 13–26 wks GA: 31%, and 27–40 wks GA: 57% non-completers, p=0.006) and multiparity with 1 or more living children (65% non-completers if any living children, compared to 45% non-completers if no living children, p=0.002). Age, race, and transportation were not predictors of failure to complete sleep apnea testing. Conclusion We have identified several predictors of pregnant patients’ failure to complete sleep apnea evaluation with objective home sleep apnea testing after referral from obstetrics. Not surprisingly, higher gestational age emerged as a strong negative predictor of referral completion, with >50% of patients referred in the third trimester not completing sleep apnea testing. Early screening and referral for sleep apnea evaluation in pregnancy should be prioritized, given the time-sensitive nature of diagnosis and therapy initiation, and demonstrated reduced completion of referrals in advanced pregnancy. Support (if any) None

Clinical application of home sleep apnea testing in children: a prospective pilot study

2021 ◽  
Author(s):  
Amee Revana ◽  
Jason Vecchio ◽  
Danielle Guffey ◽  
Charles G. Minard ◽  
Daniel G. Glaze
Keyword(s):  
Sleep Apnea ◽  
Pilot Study ◽  
Clinical Application ◽  
Prospective Pilot Study ◽  
Home Sleep Apnea Testing ◽  
Apnea Testing

scholarly journals Pediatric Home Sleep Apnea Testing

CHEST Journal ◽  
2015 ◽  
Vol 148 (6) ◽  
pp. 1382-1395 ◽  
Author(s):  
Hui-Leng Tan ◽  
Leila Kheirandish-Gozal ◽  
David Gozal
Keyword(s):  
Sleep Apnea ◽  
Home Sleep Apnea Testing ◽  
Apnea Testing

scholarly journals Addition of frontal EEG to adult home sleep apnea testing: does a more accurate determination of sleep time make a difference?

2018 ◽  
Vol 22 (4) ◽  
pp. 1179-1188 ◽  
Author(s):  
Matthew P. Light ◽  
Thalia N. Casimire ◽  
Catherine Chua ◽  
Viachaslau Koushyk ◽  
Omar E. Burschtin ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Accurate Determination ◽  
Sleep Time ◽  
Home Sleep Apnea Testing ◽  
Apnea Testing

scholarly journals Introduction to Sleep Testing

2019 ◽  
pp. 29-80
Author(s):  
Nancy Foldvary-Schaefer ◽  
Madeleine Grigg-Damberger ◽  
Reena Mehra
Keyword(s):  
Sleep Apnea ◽  
Airway Pressure ◽  
Multiple Sleep Latency Test ◽  
Sleep Laboratory ◽  
Maintenance Of Wakefulness Test ◽  
Home Sleep Apnea Testing ◽  
Multiple Sleep Latency ◽  
Apnea Testing

This chapter provides an overview of sleep testing performed inside or outside the sleep laboratory. The chapter reviews the classification of sleep studies and methodology of in-lab polysomnography and home sleep apnea testing. Specifically, the indications for and relative contraindications and limitations of both procedures are discussed. Positive airway pressure (PAP) titration procedures are reviewed and the PAP-NAP, an abbreviated daytime study for patients with sleep apnea and PAP intolerance or hesitancy, is described. The authors also discuss the methodology of, indications for, and interpretation of the multiple sleep latency test and the maintenance of wakefulness test, which are daytime studies performed to evaluate excessive daytime sleepiness. Finally, the role of actigraphy in the evaluation of sleep disorders is discussed.

scholarly journals Effect of Manual Editing of Total Recording Time: Implications for Home Sleep Apnea Testing

2017 ◽  
Vol 13 (01) ◽  
pp. 121-126 ◽  
Author(s):  
Ying Y. Zhao ◽  
Jia Weng ◽  
Daniel R. Mobley ◽  
Rui Wang ◽  
Younghoon Kwon ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Recording Time ◽  
Home Sleep Apnea Testing ◽  
Apnea Testing

scholarly journals Improving Accuracy of Home Sleep Apnea Testing

2017 ◽  
Vol 13 (01) ◽  
pp. 9-10 ◽  
Author(s):  
David Claman ◽  
Bernie Sunwoo
Keyword(s):  
Sleep Apnea ◽  
Home Sleep Apnea Testing ◽  
Improving Accuracy ◽  
Apnea Testing

scholarly journals 0605 Comparison of Sleep Specialist vs Primary Care Driven Home Sleep Apnea Testing in Routine Practice

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A231-A231
Author(s):  
K He ◽  
M Mendez ◽  
C W Atwood
Keyword(s):  
Primary Care ◽  
Sleep Apnea ◽  
Success Rate ◽  
Routine Practice ◽  
Technical Failure ◽  
Opioid Use ◽  
Hub And Spoke ◽  
Neck Size ◽  
Home Sleep Apnea Testing ◽  
Apnea Testing

Abstract Introduction Home sleep apnea testing (HSAT) has largely supplanted diagnostic polysomnography. Primary care (PC) driven HSAT utilization is common especially in rural settings that lack sleep specialist (SS) support. There have been no studies comparing appropriateness of HSAT utilization in veterans managed by SS vs. PC. Methods We use hub and spoke model to manage patients with OSA. SS selects testing for hub and PC utilizes HSAT for spoke patients. Testing is interpreted by SS. Patients referred for HSAT using WatchPAT over 4 months were compared on test failure rate, adherence to AASM guidelines for OSA diagnosis, adherence to HSAT use criteria, and diagnostic success rate (AHI ≥5) in high risk patients (STOPBANG ≥5) without significant comorbidities or HSAT contraindications compared to all comers. Results There were 125 hub and 170 spoke patients included in the analyses. Baseline characteristics were similar between sites (gender, age, BMI, Epworth sleepiness scale, neck size, STOPBANG, pacemaker dependence, and medication use affecting HSAT). Spoke patients had slightly higher prevalence of comorbidities (hypertension, cardiac arrhythmia, heart failure, COPD, stroke, and long acting opioid use). Complete HSAT failure (no data) was 2% and technical failure (monitoring time <4 hours) was 13% at both sites. Unnecessary studies primarily to confirm OSA in those previously diagnosed on therapy seeking to establish care were 3% (hub) and 21% (spoke). HSAT done in patients without significant comorbidities was 77% (hub) and 68% (spoke). Adherence to HSAT use criteria was 74% at both sites. Diagnostic success rate of prespecified and all comers was 65% vs. 60% at hub and 86% vs. 64% at spoke sites. Conclusion Adherence to AASM guidelines and HSAT use criteria was overall fair with low failure rates. Further improving HSAT protocol for SS and PC with the aim to improve diagnostic success rate and minimize unnecessary studies should be pursued. Support  

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