Comparison of the automatic analysis versus the manual scoring from ApneaLink™ device for the diagnosis of obstructive sleep apnoea syndrome
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The purpose of this study was to compare the performance of the automated detection versus the manual scoring from the ApneaLink™ device to diagnose obstructive sleep apnoea syndrome (OSAS).
All participants (96) performed the ApneaLink™ (AL) and polysomnography (PSG) simultaneously in the sleep laboratory. The two recordings were interpreted blindly. The hypopnoea criterion used for the analysis of both automatic and manual ApneaLink™ was a fall in airflow ≥50% of baseline for ≥10 s. The agreement between AL and PSG and the interobserver concordance was calculated. ROC analysis, sensitivity and specificity were assessed for the different ApneaLink™ and OSAS criteria.
Ninety patients were included (69 men; mean age, 49.6; median RDI, 13.9; median BMI, 29.3 kg/m2). The automatic apnoea/hypopnoea index (AHI-a) showed a lower agreement with the respiratory disturbance index (RDI) than the manual apnoea/hypopnoea (AHI-m) [AHI-a/RDI: intraclass correlation coefficient (ICC) 0.88 versus AHI-m/RDI: ICC 0.91]. The manual scoring (MS) showed a similar sensitivity and a higher specificity than the automatic scoring (AA) for the detection of OSAS, defined as an RDI ≥ 5 (sensitivity and specificity AA and MS: 89%/89%, 60%/86.7%, respectively). The accuracy of the automatic and manual scoring of the AL was similar when OSAS was defined as an RDI ≥ 20 or 30. The ApneaLink™ manual scoring had a very good interobserver agreement (k = 0.86).
The manual scoring of an ApneaLink™ recording was better than the automatic scoring in terms of agreement with RDI and to discriminate patients with OSAS. The hand scoring did not improve the accuracy of automatic scoring in patients with severe OSAS.
KeywordsSleep-disordered breathing Sleep apnoea Home sleep study Portable sleep study
The authors wish to thank Ms. Jaquelina Mastantuono for revising the English text.
Conflicts of interest
We declare that there were no conflicts of interest related to this investigation.
- 6.Collop NA, Anderson WM, Boehlecke B, Claman D, Goldberg R, Gottlieb DJ, Hudgel D, Sateia M, Schwab R (2007) Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable monitoring task force of the American Academy of Sleep Medicine. J Clin Sleep Med 3:737–747PubMedGoogle Scholar
- 11.Nigro CA, Serrano F, Aimaretti S, Gonzalez S, Codinardo C, Rhodius E (2010) Utility of ApneaLink for the diagnosis of sleep apnea-hypopnea syndrome. Medicina (B Aires) 70:53–59Google Scholar
- 13.Rechtschafen A, Kales A (1968) A manual of standarized technology, techniques and scoring system for sleep stages of human subjects. Brain Information Service, Los AngelesGoogle Scholar
- 14.American Sleep Disorders Association (1992) EEG arousals: scoring rules and examples: a preliminary report from the sleep disorders atlas task force of the American Sleep Disorders Association. Sleep 15:173–184Google Scholar
- 17.Consenso Nacional sobre el Síndrome Apneas-Hipopneas del Sueño del Grupo Español de Sueño. Definición y concepto, fisiopatología, clínica y exploración del SAHS (2005). Arch bronconeumol 2005; 41, Extraordinario 4: 12–29Google Scholar
- 19.Sala H, Nigro C, Rabec C, Guardia AS, Smurra M (2001) Consenso Argentino de Trastornos Respiratorios Vinculados al Sueño. Medicina (B Aires) 61:351–363Google Scholar
- 21.Pita Fernández S, Pértega Díaz S (2003) Pruebas diagnósticas. Cad Aten Prim 10:120–124Google Scholar