Erman Milton K, Stewart Deirdre, Einhorn Daniel, Gordon Nancy, Casal Eileen
Pacific Sleep Medicine Services, San Diego, CA, USA.
J Clin Sleep Med. 2007 Jun 15;3(4):387-92.
Screening for sleep apnea may be useful in a number of settings, such as preoperative testing, clinical research, and evaluation for referral to a sleep center. The purpose of the study was to validate the ApneaLink device (ResMed Corporation, Poway, Calif) for use as a screening tool for sleep apnea in clinical practice.
The ApneaLink device is a single-channel screening tool for sleep apnea that measures airflow through a nasal cannula connected to a pressure transducer, providing an apnea-hypopnea index (AHI) based on recording time. We compared the AHI from the ApneaLink device to that obtained during simultaneously conducted attended sleep-laboratory polysomnography to assess the sensitivity and specificity of the device in consecutive subjects with type 2 diabetes mellitus referred from a diabetes clinic. We also compared the AHI obtained from the ApneaLink device during a study in the subjects' homes to that obtained during the in-laboratory study. The laboratory study was performed within 2 weeks of the home study.
Fifty-nine subjects completed the study. Mean age of subjects was 57 years; mean body mass index was 33 kg/m2. The results demonstrate a high sensitivity and specificity of the at-home ApneaLink AHI compared with the AHI from the simultaneous polysomnographic study at all AHI levels, with the best results at an AHI of > or =15 events per hour (sensitivity 91%, specificity 95%). The AHI comparison from the home and laboratory studies also demonstrates good sensitivity and specificity at AHI levels of > or =15 and > or =20 events per hour (sensitivity 76%, specificity 94%, for both).
Given the prevalence of sleep apnea in the adult population and in specific comorbid conditions, a screening tool may be useful in many diagnostic settings. This study demonstrates that the ApneaLink device provides reliable information, is a simple, easy-to-use device, and is highly sensitive and specific in calculating AHI, when compared with the AHI obtained from full polysomnography.
睡眠呼吸暂停的筛查在许多情况下可能是有用的，如术前检查、临床研究以及转介至睡眠中心的评估。本研究的目的是验证ApneaLink设备（瑞思迈公司，加利福尼亚州波威市）在临床实践中作为睡眠呼吸暂停筛查工具的有效性。
ApneaLink设备是一种用于睡眠呼吸暂停的单通道筛查工具，它通过连接到压力传感器的鼻导管测量气流，根据记录时间提供呼吸暂停低通气指数（AHI）。我们将ApneaLink设备测得的AHI与同时进行的有人员值守的睡眠实验室多导睡眠图检查期间测得的AHI进行比较，以评估该设备在从糖尿病诊所转诊的连续2型糖尿病患者中的敏感性和特异性。我们还比较了在受试者家中进行的一项研究中ApneaLink设备测得的AHI与在实验室研究中测得的AHI。实验室研究在家庭研究后的2周内进行。
59名受试者完成了研究。受试者的平均年龄为57岁；平均体重指数为33kg/m²。结果表明，在所有AHI水平下，与同时进行的多导睡眠图研究测得的AHI相比，家庭使用的ApneaLink设备测得的AHI具有较高的敏感性和特异性；在AHI≥15次/小时时效果最佳（敏感性91%，特异性95%）。家庭和实验室研究的AHI比较在AHI水平≥15次/小时和≥20次/小时时也显示出良好的敏感性和特异性（两者的敏感性均为76%，特异性均为94%）。
鉴于睡眠呼吸暂停在成年人群和特定合并症中的患病率，一种筛查工具在许多诊断环境中可能是有用的。本研究表明，与从全夜多导睡眠图获得的AHI相比，ApneaLink设备能提供可靠信息，是一种简单、易于使用的设备，并且在计算AHI时具有高度的敏感性和特异性。
