Department of Medicine and Therapeutics, Division of Respiratory Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Intern Med J. 2009 Nov;39(11):757-62. doi: 10.1111/j.1445-5994.2008.01827.x. Epub 2008 Nov 3.
Polysomnography (PSG) is currently the standard diagnostic procedure for sleep apnoea. This study evaluates the diagnostic accuracy of a portable recording device, ApneaLink (AL; ResMed, Poway, CA, USA) for detection of sleep apnoea in comparisons against PSG.
The AL device is a three-channel screening tool that measures airflow through a nasal pressure transducer, oximetry and pulse, providing an apnoea-hypopnoea index (AHI) based on recording time. Nocturnal PSG (Alice 4; Healthdyne, Atlanta, GA, USA), with airflow measured by a nasal pressure transducer (ProTech PTAF2; ProTech, Woodinville, WA, USA) and AL recordings were carried out simultaneously in consecutive patients with suspected obstructive sleep apnoea syndrome (OSAS). The PSG recordings were analysed manually by a blinded investigator. The oxygen desaturation index of AL was also compared against the AHI based on PSG.
Fifty consecutive subjects with symptoms of OSAS were recruited with mean age of 50 years and body mass index of 27.9 kg/m2. The AHI obtained by the AL device correlated closely to that obtained by PSG (Pearson correlation, r= 0.978, P < 0.001), whereas the correlation between PSG AHI and oxygen desaturation index by AL was also strong (r= 0.895, P < 0.001). Comparison of AHI based on the AL against the PSG demonstrated high sensitivity and specificity at AHI > or =10/h (sensitivity 0.977 and specificity 1.0) and at AHI > or =20/h (sensitivity 0.969 and specificity 1.0).
The AL portable monitoring device is highly sensitive and specific in quantifying the apnoea-hypopnoea index when compared against hospital based polysomnography in patients with suspected OSAS. The simple device may be useful for screening and diagnostic purpose when access to PSG is limited.
多导睡眠图（PSG）是目前诊断睡眠呼吸暂停的标准程序。本研究评估了一种便携式记录设备 ApneaLink（AL；ResMed，加利福尼亚州 Poway）的诊断准确性，该设备用于检测睡眠呼吸暂停，与 PSG 进行比较。
AL 设备是一种三通道筛查工具，通过鼻压力传感器测量气流，通过血氧仪和脉搏提供基于记录时间的呼吸暂停低通气指数（AHI）。连续的疑似阻塞性睡眠呼吸暂停综合征（OSAS）患者同时进行夜间 PSG（Alice 4；Healthdyne，佐治亚州亚特兰大）和 AL 记录，PSG 记录由鼻压力传感器（ProTech PTAF2；ProTech，华盛顿州 Woodinville）测量。PSG 记录由一位盲法研究人员进行手动分析。还比较了 AL 的氧减饱和指数与 PSG 基于 PSG 的 AHI。
50 名有 OSAS 症状的连续患者被招募，平均年龄 50 岁，体重指数 27.9kg/m2。AL 设备获得的 AHI 与 PSG 密切相关（Pearson 相关，r=0.978，P<0.001），而 PSG AHI 与 AL 的氧减饱和指数也有很强的相关性（r=0.895，P<0.001）。基于 AL 的 AHI 与 PSG 的比较表明，在 AHI>或=10/h（灵敏度 0.977，特异性 1.0）和 AHI>或=20/h（灵敏度 0.969，特异性 1.0）时，具有很高的灵敏度和特异性。
在疑似 OSAS 患者中，与基于医院的多导睡眠图相比，AL 便携式监测设备在量化呼吸暂停低通气指数方面具有高度的敏感性和特异性。当 PSG 受限时，该简单设备可能对筛查和诊断有用。
