Diagnostic Accuracy of the Alice NightOne Single-Belt Monitor for Obstructive Sleep Apnea and Reliability of Wireless Data Transfer.

OBJECTIVE

To validate the performance of a single-belt type 3 portable monitor Alice NightOne for diagnosis of obstructive sleep apnea and its reliability in remote data transmission.

METHODS

Our study included two parts: in-laboratory Alice NightOne (ANO) monitoring (ANO) and home sleep apnea testing (HSAT) using ANO (ANO). For ANO, the participants underwent polysomnography (PSG) with ANO simultaneously. For ANO, the participants completed unattended overnight ANO out of sleep center and PSG was performed in another night. The ANO recordings were transmitted to cloud database wirelessly in addition to traditional wire transmission. Message digest-5 (MD5) algorithm was utilized to verify the integrity of the cloud data.

RESULTS

Ninety-one ANO and 170 ANO recordings were analyzed. Both the respiratory event index (REI) on ANO and that on ANO were lower than the corresponding apnea-hypopnea index (AHI) on PSG (24.9 ± 20.5 events/h vs 31.6 ± 25.0 events/h, and 26.7 ± 17.0 events/h vs 35.3 ± 21.2 events/h respectively, P < 0.001). Bland-Altman analysis of REI on ANO versus AHI on PSG showed a mean difference (95% confidence interval) of -6.7 (-8.4, -4.9) events/h. For REI on ANO versus AHI on PSG, the difference is -8.0 (-9.9, -6.0) events/h. With threshold of REI ≥ 5 events/h for OSA diagnosis, ANO had 98.8% sensitivity, 90.0% specificity, 99.4% positive predictive value. The MD5 algorithm verified the identity between uploaded cloud data and original data.

CONCLUSION

With single thoracoabdominal belt, Alice NightOne can help diagnosis of obstructive sleep apnea with good sensitivity and specificity, though it may underestimate AHI. Furthermore, it provides reliable support based on solid data teletransmission and scoring synchronization, which may increase the ability of diagnosis and management of OSA through telemedicine.