Romem Ayal, Romem Anat, Koldobskiy Dafna, Scharf Steven M
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland, Baltimore, MD.
Bouve College of Health Sciences, School of Nursing, Northeastern University, Boston, MA.
J Clin Sleep Med. 2014 Mar 15;10(3):285-90. doi: 10.5664/jcsm.3530.
Increasing awareness of the high prevalence of obstructive sleep apnea (OSA) and its impact on health in conjunction with high cost, inconvenience, and short supply of in-lab polysomnography (PSG) has led to the development of more convenient, affordable, and accessible diagnostic devices. We evaluated the reliability and accuracy of a single-channel (finger pulse-oximetry) photoplethysmography (PPG)-based device for detection of OSA (Morpheus Ox).
Among a cohort of 73 patients referred for in-laboratory evaluation of OSA, 65 were simultaneously monitored with the PPG based device while undergoing PSG. Among these, 19 had significant cardiopulmonary comorbidities. Using the PSG as the "gold standard," the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), as well as the positive likelihood ratio (+LR) for an apnea hypopnea index (AHI)PSG > 5/h and AHIPSG > 15/h were calculated for the PPG.
Valid results were available for 65 subjects. Mean age: 52.1 ± 14.2, Male: 52%, and BMI: 36.3 ± 9.7 kg/m(2). Positive correlation was found between PPG-derived and PSG-derived AHI (r = 0.81, p < 0.001). For AHIPSG > 5/h, sensitivity was 80%, specificity 86%, PPV 93%, NPV 68%, and +LR was 5.9. For AHIPSG > 15/h, sensitivity was 70%, specificity 91%, PPV 80%, NPV 85%, and +LR was 7.83. The corresponding areas under the receiver operator curves were 0.91 and 0.9.
PPG-derived data compare well with simultaneous in-lab PSG in the diagnosis of suspected OSA among patients with and without cardiopulmonary comorbidities.
Romem A; Romem A; Koldobskiy D; Scharf SM. Diagnosis of obstructive sleep apnea using pulse oximeter derived photoplethysmographic signals.
人们对阻塞性睡眠呼吸暂停（OSA）的高患病率及其对健康的影响的认识不断提高，同时实验室多导睡眠图（PSG）成本高、不便且供应短缺，这促使了更便捷、经济且易于使用的诊断设备的开发。我们评估了一种基于单通道（手指脉搏血氧饱和度测定法）光电容积脉搏波描记法（PPG）的设备（Morpheus Ox）用于检测OSA的可靠性和准确性。
在73名被转诊至实验室进行OSA评估的患者队列中，65名患者在接受PSG检查时同时使用基于PPG的设备进行监测。其中，19名患者有明显的心肺合并症。以PSG作为“金标准”，计算PPG对于呼吸暂停低通气指数（AHI）PSG > 5/h和AHIPSG > 15/h的敏感性、特异性、阴性预测值（NPV）、阳性预测值（PPV）以及阳性似然比（+LR）。
65名受试者获得了有效结果。平均年龄：52.1 ± 14.2岁，男性：52%，体重指数（BMI）：36.3 ± 9.7 kg/m²。发现PPG得出的AHI与PSG得出的AHI之间存在正相关（r = 0.81，p < 0.001）。对于AHIPSG > 5/h，敏感性为80%，特异性为86%，PPV为93%，NPV为68%，+LR为5.9。对于AHIPSG > 15/h，敏感性为70%，特异性为91%，PPV为80%，NPV为85%，+LR为7.83。相应的受试者工作特征曲线下面积分别为0.91和0.9。
在有或无心肺合并症的疑似OSA患者的诊断中，PPG得出的数据与同时进行的实验室PSG数据具有良好的可比性。
Romem A; Romem A; Koldobskiy D; Scharf SM. 使用脉搏血氧仪得出的光电容积脉搏波信号诊断阻塞性睡眠呼吸暂停
