Alshaer Hisham, Fernie Geoff R, Tseng Wen-Hou, Bradley T Douglas
Sleep Research Laboratory and Home, Community and Institutional Environments Team, Toronto Rehabilitation Institute, University Health Network, Toronto Rehabilitation Institute, Toronto, ON, Canada.
Toronto Rehabilitation Institute, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada.
Sleep Med. 2016 Jun;22:91-96. doi: 10.1016/j.sleep.2015.11.003. Epub 2015 Dec 2.
Sleep apnea (SA) is a common, serious, but underdiagnosed condition. There is a need for more accessible and economic means of diagnosing SA in the home. The aim of this study was to test the validity of a cordless acoustic portable device (BresoDx™) for home diagnosis of SA compared with standard polysomnography (PSG).
A total of 135 subjects underwent full overnight PSG and simultaneous recording of breath sounds by BresoDx in the sleep laboratory. Acoustic data extracted from BresoDx were analyzed using validated computer acoustic algorithms. The PSG-derived apnea-hypopnea index (AHI-p) and the acoustic AHI (AHI-a) were calculated and compared. A subset of 100 subjects used the device in a subsequent night in their home from which home AHI (AHI-h) was determined.
The correlation between AHI-a and simultaneous AHI-p was 95.2% and diagnostic accuracy of BresoDx ranged between 88.9% and 93.3% around AHI cutoffs of 5-15. In the home, AHI-h did not differ significantly from AHI-p (p = 0.60). Using an AHI-p cutoff ≥ 10 BresoDx's accuracy was 81%. Of the 100 subjects, 81 (81%) had low inter-night variability measured by a difference between home AHI-h and PSG AHI-p < 10 event/h, while 19% had higher inter-night variability.
AHI determined using BresoDx was in excellent agreement with simultaneous AHI-p. The majority of patients had a consistent AHI in their subsequent home study with very good overall diagnostic accuracy. We conclude that BresoDx is a reliable device for diagnosing SA that can be used by subjects, unattended in their own homes.
睡眠呼吸暂停（SA）是一种常见、严重但诊断不足的病症。需要有更便捷且经济的家庭诊断SA的方法。本研究的目的是测试一种无线声学便携式设备（BresoDx™）用于家庭诊断SA与标准多导睡眠图（PSG）相比的有效性。
共有135名受试者在睡眠实验室接受了整夜的全夜PSG检查，并同时使用BresoDx记录呼吸音。从BresoDx提取的声学数据使用经过验证的计算机声学算法进行分析。计算并比较PSG得出的呼吸暂停低通气指数（AHI-p）和声学AHI（AHI-a）。100名受试者的一个子集在随后的夜晚在家中使用该设备，由此确定家庭AHI（AHI-h）。
AHI-a与同时的AHI-p之间的相关性为95.2%，在AHI临界值为5 - 15时，BresoDx的诊断准确性在88.9%至93.3%之间。在家中，AHI-h与AHI-p无显著差异（p = 0.60）。使用AHI-p临界值≥10时，BresoDx的准确性为81%。在100名受试者中，81名（81%）通过家庭AHI-h与PSG AHI-p之间的差异<10次事件/小时测量的夜间变异性较低，而19%的夜间变异性较高。
使用BresoDx确定的AHI与同时的AHI-p高度一致。大多数患者在随后的家庭研究中AHI一致，总体诊断准确性非常好。我们得出结论，BresoDx是一种可靠的诊断SA的设备，受试者可以在自己家中无人值守的情况下使用。
