Khor Yet H, Khung Su-Wei, Ruehland Warren R, Jiao Yuxin, Lew Jeremy, Munsif Maitri, Ng Yvonne, Ridgers Anna, Schulte Max, Seow Daniel, Soon William, Churchward Thomas, Howard Mark E
Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Institute for Breathing and Sleep, Heidelberg, Victoria, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.
Sleep Med Rev. 2023 Apr;68:101743. doi: 10.1016/j.smrv.2022.101743. Epub 2023 Jan 6.
Obstructive sleep apnea (OSA) is a significant healthcare burden affecting approximately one billion people worldwide. The prevalence of OSA is rising with the ongoing obesity epidemic, a key risk factor for its development. While in-laboratory polysomnography (PSG) is the gold standard for diagnosing OSA, it has significant drawbacks that prevent widespread use. Portable devices with different levels of monitoring are available to allow remote assessment for OSA. To better inform clinical practice and research, this comprehensive systematic review evaluated diagnostic performances, study cost and patients' experience of different levels of portable sleep studies (type 2, 3, and 4), as well as wearable devices and non-contact systems, in adults. Despite varying study designs and devices used, portable diagnostic tests are found to be sufficient for initial screening of patients at risk of OSA. Future studies are needed to evaluate cost effectiveness with the incorporation of portable diagnostic tests into the diagnostic pathway for OSA, as well as their application in patients with chronic respiratory diseases and other comorbidities that may affect test performance.
阻塞性睡眠呼吸暂停（OSA）是一项重大的医疗负担，影响着全球约10亿人。随着肥胖症的不断流行，OSA的患病率正在上升，肥胖是其发病的一个关键风险因素。虽然实验室多导睡眠图（PSG）是诊断OSA的金标准，但它存在重大缺陷，阻碍了其广泛应用。现在有不同监测水平的便携式设备可用于对OSA进行远程评估。为了更好地指导临床实践和研究，这项全面的系统评价评估了不同水平的便携式睡眠研究（2型、3型和4型）以及可穿戴设备和非接触系统在成人中的诊断性能、研究成本和患者体验。尽管研究设计和使用的设备各不相同，但便携式诊断测试被发现足以对有OSA风险的患者进行初步筛查。未来需要开展研究，以评估将便携式诊断测试纳入OSA诊断途径的成本效益，以及它们在可能影响测试性能的慢性呼吸道疾病和其他合并症患者中的应用。
