Sleep and Breathing

, Volume 10, Issue 2, pp 62–69 | Cite as

Nasal pressure recordings to detect obstructive sleep apnea

  • Fernanda Ribeiro de Almeida
  • Najib T. Ayas
  • Ryo Otsuka
  • Hiroshi Ueda
  • Peter Hamilton
  • Frank C. Ryan
  • Alan A. Lowe
Original Article

Abstract

Obstructive sleep apnea (OSA) is a common disease. Given the costs of in-laboratory polysomnography (PSG), alternative ambulatory methods for accurate diagnosis are desirable. The objective of this study was to evaluate the performance of a simple device (SleepCheck) to identify patients with sleep apnea. A total of 30 consecutive patients with suspected OSA syndrome referred to the sleep clinic were prospectively evaluated with standard PSG and SleepCheck simultaneously during an in-laboratory, supervised full-night diagnostic study. The PSG apnea and hypopnea index (AHI) was evaluated according to standard criteria, and SleepCheck assessed the respiratory disturbance index (RDI) based on nasal cannula pressure fluctuations. Compared to the full-night PSG, SleepCheck systematically overscored respiratory events (the mean difference between SleepCheck RDI and PSG AHI was 27.4±13.3 events per hour). This overscoring was in part related to normal physiologic decreases in flow during rapid eye movement sleep or after an arousal. However, there was reasonable correlation between AHI and RDI (r=0.805). Receiver operating characteristic curves with threshold values of AHI of 10 and 20/h demonstrated areas under the curves (AUCs) of 0.915 and 0.910, respectively. Optimum combinations of sensitivity and specificity for these thresholds were calculated as 86.4/75.0 and 88.9/81.0, respectively. Overall, the SleepCheck substantially overscored apneas and hypopneas in patients with suspected OSA. However, after correction of the bias, the SleepCheck had reasonable accuracy with an AUC, sensitivity, and specificity similar to other ambulatory type 4 devices currently available.

Keywords

Sleep apnea Nasal cannula Screening Diagnosis Home monitoring 

Notes

Acknowledgements

The authors wish to thank Mrs. Ingrid Ellis for her editorial assistance in the final preparation of the manuscript. We are grateful for the statistical analysis provided by Ms. Mary Wong. The present study was supported by CNPq (Brazilian Government), who provided a scholarship to the first author (F.R.A.). One of the authors (N.T.A.) is supported by a Michael Smith Foundation for Health Research Scholar Award, a CIMR/BCLA new investigator award, and a departmental scholar award at UBC. In addition, SleepCheck was provided by IM Systems Inc., Baltimore.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Fernanda Ribeiro de Almeida
    • 1
  • Najib T. Ayas
    • 2
  • Ryo Otsuka
    • 3
  • Hiroshi Ueda
    • 1
  • Peter Hamilton
    • 4
  • Frank C. Ryan
    • 5
  • Alan A. Lowe
    • 1
  1. 1.Division of Orthodontics, Department of Oral Health Sciences, Faculty of DentistryThe University of British ColumbiaVancouverCanada
  2. 2.Centre for Clinical Epidemiology and EvaluationVancouver Coastal Health Research InstituteVancouverCanada
  3. 3.Maxillofacial Orthognathics, Maxillofacial/Neck ReconstructionGraduate School of Tokyo Medical and Dental UniversityTokyoJapan
  4. 4.Sleep Laboratory, Vancouver General HospitalVancouverCanada
  5. 5.Department of Medicine, Division of Respiratory Medicine, Faculty of MedicineThe University of British ColumbiaVancouverCanada

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