在超重和肥胖青少年中，将WatchPAT与多导睡眠图测量的呼吸暂停低通气指数及阻塞性睡眠呼吸暂停严重程度进行比较。

Comparison of WatchPAT to polysomnography measurement of apnea-hypopnea index and obstructive sleep apnea severity in adolescents with overweight and obesity.

作者信息

Dobbin Mia L, Bernard Angel, Pyle Laura, Friedman Norman, Cree Melanie G, Hawkins Stephen M M, Simon Stacey L

机构信息

Rocky Vista University College of Osteopathic Medicine, Parker, Colorado.

Children's Hospital Colorado, Aurora, Colorado.

出版信息

J Clin Sleep Med. 2025 Apr 1;21(4):695-702. doi: 10.5664/jcsm.11530.

DOI:10.5664/jcsm.11530

PMID:39745453

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11965089/

Abstract

STUDY OBJECTIVES

The prevalence of obstructive sleep apnea (OSA) increases dramatically in adolescents with overweight or obesity. The gold standard for diagnosis of OSA is in-laboratory polysomnography (PSG). However, access to PSG can be challenging, necessitating development of alternative devices. This study aimed to compare the accuracy of WatchPAT, a device that indirectly detects apnea and hypopnea events through peripheral arterial tonometry, to PSG in adolescents with overweight and obesity.

METHODS

Thirty-eight participants (15.5 ± 1.6 years; 76% female; 40% Hispanic/Latino; body mass index 97.7 ± 2.0 percentile) were analyzed. Correlation, agreement, sensitivity, specificity, and concordance between WatchPAT with PSG-derived measures of apnea-hypopnea index (AHI) and OSA severity were conducted. A subset (n = 21) underwent self-reported assessment of nasal flow sensor reliability and video characteristics to evaluate possible underestimation of PSG-assessed AHI.

RESULTS

Mean bias between WatchPAT- and PSG-derived AHI was 16.9 ± 13.4 events/h (95% confidence interval 12.5-21.3). WatchPAT overestimated OSA severity compared to PSG in 89% of participants. Sensitivity was 62-100% and specificity was 5.5-32% across all OSA severity levels. Of the subset with self-reported assessment of PSG data, 38% had nasal flow sensor reliability < 75%, 14% had underestimated AHI, and 28% had probably underestimated AHI. However, these characteristics did not fully explain the discrepancy between WatchPAT and PSG measurements.

CONCLUSIONS

The WatchPAT device showed a significant discrepancy compared to the gold-standard PSG in measurement of AHI and accuracy of OSA severity in adolescents with overweight or obesity. Future research is needed to understand pathophysiological differences to enhance assessment of OSA in this high-risk population.

CITATION

Dobbin ML, Bernard A, Pyle L, et al. Comparison of WatchPAT to polysomnography measurement of apnea-hypopnea index and obstructive sleep apnea severity in adolescents with overweight and obesity. . 2025;21(4):695-702.

摘要

研究目的

超重或肥胖青少年中阻塞性睡眠呼吸暂停（OSA）的患病率显著增加。OSA诊断的金标准是实验室多导睡眠图（PSG）。然而，进行PSG检查可能具有挑战性，因此需要开发替代设备。本研究旨在比较通过外周动脉张力测定间接检测呼吸暂停和低通气事件的WatchPAT设备与超重和肥胖青少年的PSG的准确性。

方法

对38名参与者（年龄15.5±1.6岁；76%为女性；40%为西班牙裔/拉丁裔；体重指数第97.7±2.0百分位）进行了分析。对WatchPAT与PSG得出的呼吸暂停低通气指数（AHI）和OSA严重程度测量值之间的相关性、一致性、敏感性、特异性和一致性进行了评估。对一个子集（n = 21）进行了鼻流量传感器可靠性和视频特征的自我报告评估，以评估PSG评估的AHI可能被低估的情况。

结果

WatchPAT得出的AHI与PSG得出的AHI之间的平均偏差为16.9±13.4次/小时（95%置信区间12.5 - 21.3）。在89%的参与者中，与PSG相比，WatchPAT高估了OSA严重程度。在所有OSA严重程度水平上，敏感性为62% - 100%，特异性为5.5% - 32%。在对PSG数据进行自我报告评估的子集中，38%的人鼻流量传感器可靠性<75%，14%的人AHI被低估，28%的人可能低估了AHI。然而，这些特征并不能完全解释WatchPAT与PSG测量值之间的差异。