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Use of a screening tool for detection of sleep-disordered breathing

Published online by Cambridge University Press:  18 February 2009

A L Clark*
Affiliation:
Academic Cardiology, Castle Hill Hospital, Hull, UK
S Crabbe
Affiliation:
Respiratory Medicine, Castle Hill Hospital, Hull, UK
A Aziz
Affiliation:
Respiratory Medicine, Castle Hill Hospital, Hull, UK
P Reddy
Affiliation:
Academic Cardiology, Castle Hill Hospital, Hull, UK
M Greenstone
Affiliation:
Respiratory Medicine, Castle Hill Hospital, Hull, UK
*
Address for correspondence: Dr Andrew L Clark, Reader and Honorary Consultant Cardiologist, Castle Hill Hospital, Castle Road, Cottingham, Hull HU16 5JQ, UK. E-mail: [email protected]

Abstract

Background:

Sleep apnoea, whether obstructive or central, is usually diagnosed by polysomnography. A simpler tool for screening high risk populations may be of value.

Methods:

We compared a portable device using nasal pressure cannulae and a high-sensitivity pressure sensor (the ApneaLink®) with our standard polysomnography technique for diagnosing sleep apnoea (using the Embletta® device), in 67 patients being investigated for possible sleep apnoea. The patients' average age was 52.6, 79 per cent were male, the mean body mass index was 32.3, and the mean Epworth sleepiness score was 13.0.

Results:

Twenty-five patients (45 per cent) were identified as having an apnoea–hypopnoea index of >15, as measured by the Embletta. The mean (standard deviation) apnoea–hypopnoea index was 21.5 ± 23.0 as measured by the Embletta and 24.3 ± 26.2 as measured by the ApneaLink. The sensitivity of the ApneaLink for an apnoea–hypopnoea index cut-off point of 15 was 92 per cent and the specificity was 96.7 per cent. The negative predictive value of the ApneaLink for an apnoea–hypopnoea index of ≤15 was 94 per cent.

Conclusions:

The ApneaLink is a useful tool for screening patients thought to have possible sleep apnoea, and for selecting patients for definitive diagnostic testing.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

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References

1 Young, T, Palta, M, Dempsey, J, Skatrud, J, Weber, S, Badr, S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230–5CrossRefGoogle ScholarPubMed
2 Bixler, E, Vgontzas, AN, Ten Have, T, Tyson, K, Kales, A. Effects of age on sleep apnea in men. Am J Respir Crit Care Med 1998;157:144–8CrossRefGoogle ScholarPubMed
3 Bixler, E, Vgontzas, AN, Lin, HM, Ten Have, T, Rein, J, Vela-Bueno, A et al. Prevalence of sleep-disordered breathing in women. Am J Respir Crit Care Med 2001;163:608–13CrossRefGoogle ScholarPubMed
4 Durán, J, Esnaola, S, Rubio, R, Iztueta, A. Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30–70 yr. Am J Respir Crit Care Med 2001;163:685–9CrossRefGoogle Scholar
5 Young, T, Shahar, E, Nieto, FJ, Redline, S, Newman, AB, Gottlieb, DJ et al. Sleep Heart Health Study Research Group. Predictors of sleep-disordered breathing in community-dwelling adults. Arch Intern Med 2002;162:893900CrossRefGoogle Scholar
6 Oldenburg, O, Lamp, B, Faber, L, Teschler, H, Horstkotte, D, Topfer, V. Sleep-disordered breathing in patients with symptomatic heart failure: a contemporary study of prevalence in and characteristics of 700 patients. Eur J Heart Fail 2007;9:251–7CrossRefGoogle ScholarPubMed
7 Peker, Y, Hedner, J, Norum, J, Kraiczi, H, Carlson, J. Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up. Am J Respir Crit Care Med 2002;166:159–65CrossRefGoogle Scholar
8 Peker, Y, Hedner, J, Kraiczi, H, Löth, S. Respiratory disturbance index; an independent predictor of mortality in coronary artery disease. Am J Respir Crit Care Med 2000;162:81–6CrossRefGoogle ScholarPubMed
9 Schafer, H, Koehler, U, Ploch, T, Peter, JH. Sleep-related myocardial ischemia and sleep structure in patients with obstructive sleep apnea and coronary heart disease. Chest 1997;111:387–93CrossRefGoogle ScholarPubMed
10 Jenkinson, C, Davies, RJ, Mullins, R, Stradling, JR. Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial. Lancet 1999;353:2100CrossRefGoogle ScholarPubMed
11 Engleman, HM, Kingshott, RN, Wraith, PK, Mackay, TW, Deary, IJ, Douglas, NJ. Randomized placebo-controlled crossover trial of continuous positive airway pressure for mild sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 1999;159:461–7CrossRefGoogle ScholarPubMed
12 Chiner, E, Signes-Costa, J, Arriero, JM, Marco, J, Fuentes, I, Sergado, A. Nocturnal oximetry for the diagnosis of the sleep apnoea syndrome: a method to reduce the number of polysomnographies? Thorax 1999;54:968–71CrossRefGoogle ScholarPubMed
13 Ramsey, R, Mehra, R, Strohl, KP. Variations in physician interpretation of overnight pulse oximetry monitoring. Chest 2007;132:852–9CrossRefGoogle ScholarPubMed