Yamada Yuriko, Kasagi Satoshi, Tamura Haruko, Kawana Fusae, Tomita Yasuhiro, Narui Koji, Kasai Takatoshi
Clinical Physiology, Toranomon Hospital, Tokyo, Japan; Department of Sleep Respiratory Medicine, Toranomon Hospital, Tokyo, Japan.
Department of Sleep Respiratory Medicine, Toranomon Hospital, Tokyo, Japan.
Ann Palliat Med. 2020 Sep;9(5):2895-2902. doi: 10.21037/apm-20-384. Epub 2020 Sep 10.
Portable monitoring devices have been developed for in-home screening and to aid in the diagnosis of sleep disordered breathing (SDB) while increasing accessibility and reducing costs. Although there are many different devices available in the market, most have not undergone rigorous validation. Therefore, although such devices are promising, more research on their clinical utility is necessary. The purpose of this study was to assess the clinical utility of a type 4 home sleep apnea test (HSAT) as an in-home screening for SDB.
We investigated consecutive subjects who underwent in-laboratory overnight polysomnography following in-home screening using HSAT. We evaluated the correlation between apnea-hypopnea index (AHI) by in-laboratory overnight polysomnography and by HSAT and evaluated the sensitivity and specificity for AHI ≥5 and AHI ≥30 by the receiver operating characteristic (ROC) analysis.
Finally, data of 387 participants (86.8% men, mean age 55.3±13.3 years and body mass index 25.1±4.1 kg/m2) were assessed. In all patients, AHI by HSAT correlated significantly with AHI by polysomnography (r=0.670, P<0.001). The area under curves of ROC for AHI ≥5 and AHI ≥30 were 0.854±0.029 and 0.841±0.022, respectively. The best cut-off of AHI by HSAT for detecting AHI by polysomnography ≥5 was 10.3 events/h (sensitivity, 82.8%; and specificity, 76.0%), and AHI by HSAT for detecting AHI by polysomnography ≥30 was 24.5 events/h (sensitivity, 75.8%; and specificity, 80.4%).
This type 4 HSAT may have potential as a screening tool for SDB and thus have sufficient clinical utility.
便携式监测设备已被开发用于家庭筛查，并有助于睡眠呼吸障碍（SDB）的诊断，同时提高了可及性并降低了成本。尽管市场上有许多不同的设备，但大多数尚未经过严格验证。因此，尽管此类设备前景广阔，但仍需要对其临床效用进行更多研究。本研究的目的是评估4型家庭睡眠呼吸暂停测试（HSAT）作为SDB家庭筛查的临床效用。
我们调查了连续接受HSAT家庭筛查后进行实验室过夜多导睡眠图检查的受试者。我们评估了实验室过夜多导睡眠图检查和HSAT得出的呼吸暂停低通气指数（AHI）之间的相关性，并通过受试者操作特征（ROC）分析评估了AHI≥5和AHI≥30的敏感性和特异性。
最终，评估了387名参与者的数据（86.8%为男性，平均年龄55.3±13.3岁，体重指数25.1±4.1kg/m²）。在所有患者中，HSAT得出的AHI与多导睡眠图检查得出的AHI显著相关（r=0.670，P<0.001）。AHI≥5和AHI≥30的ROC曲线下面积分别为0.854±0.029和0.841±0.022。HSAT检测多导睡眠图检查得出的AHI≥5的最佳截断值为10.3次/小时（敏感性为82.8%；特异性为76.0%），HSAT检测多导睡眠图检查得出的AHI≥30的最佳截断值为24.5次/小时（敏感性为75.8%；特异性为80.4%）。
这种4型HSAT可能有潜力作为SDB的筛查工具，因此具有足够的临床效用。
