Wang Wan-Er, Han Fang, Gao He, Zhu Guang-Qing, Liu Ju-Qin, Li Jing
Sleep Disorder Center, General Hospital of Air Force, Beijing 100036, China.
Zhonghua Yi Xue Za Zhi. 2008 Sep 9;88(34):2395-8.
To assess the diagnostic value of oxygen saturation combined with airflow (OF) monitoring for diagnosis of obstructive sleep apnea hypopnea syndrome (OSAHS).
Sixty-two subjects including suspected OSAHS and non-snorers underwent overnight polysomnography (PSG) and OF monitoring simultaneously in sleep laboratory. The apnea-hypopnea index (AHI), lowest oxygen saturation (LSaO(2)), and oxygen desaturation index (ODI) recorded by OF were compared with those recorded by PSG. The AHI and ODI data that showed skew distribution underwent square root transformation to approximate to normal distribution. Pair t test was used for difference hypothesis test. The agreement between the two measures was analyzed using Bland-Altman plot.
Forty-five of the 62 subjects were diagnosed as with OSAHS based on PSG with the mean AHI value of (40 +/- 27) events per hour. The mean AHI values derived from OF (OF-AHI) and PSG (PSG-AHI) according to total sleep time were (28 +/- 26) and (29 +/- 28) times per hour respectively, and those after square root transformation were (4.6 +/- 2.7) and (4.7 +/- 2.7) times per hour respectively (P = 0.08). The mean LSaO(2) derived from OF (OF-LSaO(2)) was (82 +/- 11)%, not significantly different from that derived from PSG (PSG-LSaO(2)) [(82 +/- 10)%, P = 0.65]. The ODI derived from OF (OF-ODI) after square root transformation was (3.0 +/- 2.4) times/h, significantly lower than that derived from PSG (PSG-ODI) after square root transformation [(4.0 +/- 2.9) times/h, P = 0.00]. The Bland-Altman plot revealed a good agreement between the OF-AHI and PSG-AHI in non-OSAHS people and patients with mild OSAHS (P = 0.28), however, the OF-AHI was lower than PSG-AHI (P = 0.00) in the patients with moderate to severe OSAHS. There was no significant difference between OF-LSaO(2) and PSG-LSaO2 (P = 0.65).
There is a good agreement between OF and PSG for AHI and LSaO(2). OF can be used to screen patients with suspected OSAHS in high risk population. However, OF tends to underestimate the AHI in moderate to severe OSAHS so additional manual analysis is necessary to confirm the diagnosis.
评估血氧饱和度联合气流（OF）监测对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的诊断价值。
62名受试者，包括疑似OSAHS患者和非打鼾者，在睡眠实验室同时接受整夜多导睡眠图（PSG）和OF监测。将OF记录的呼吸暂停低通气指数（AHI）、最低血氧饱和度（LSaO₂）和血氧饱和度下降指数（ODI）与PSG记录的进行比较。对呈偏态分布的AHI和ODI数据进行平方根变换以近似正态分布。采用配对t检验进行差异假设检验。使用Bland-Altman图分析两种测量方法之间的一致性。
62名受试者中45名根据PSG诊断为OSAHS，平均AHI值为每小时（40±27）次事件。根据总睡眠时间，OF得出的平均AHI值（OF-AHI）和PSG得出的平均AHI值（PSG-AHI）分别为每小时（28±26）次和（29±28）次，平方根变换后分别为每小时（4.6±2.7）次和（4.7±2.7）次（P = 0.08）。OF得出的平均LSaO₂（OF-LSaO₂）为（82±11）%，与PSG得出的[（82±10）%]无显著差异（P = 0.65）。平方根变换后OF得出的ODI（OF-ODI）为每小时（3.0±2.4）次，显著低于平方根变换后PSG得出的[（4.0±2.9）次/小时，P = 0.00]。Bland-Altman图显示，在非OSAHS人群和轻度OSAHS患者中，OF-AHI与PSG-AHI之间具有良好的一致性（P = 0.28），然而，在中度至重度OSAHS患者中，OF-AHI低于PSG-AHI（P = 0.00）。OF-LSaO₂与PSG-LSaO₂之间无显著差异（P = 0.65）。
OF与PSG在AHI和LSaO₂方面具有良好的一致性。OF可用于在高危人群中筛查疑似OSAHS患者。然而，OF往往会低估中度至重度OSAHS患者的AHI，因此需要额外的人工分析来确诊。
