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Novel mathematical processing method of nocturnal oximetry for screening patients with suspected sleep apnoea syndrome

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Abstract

Aim

Polysomnography (PSG) is the current standard for diagnosing sleep apnea syndrome (SAS). A reliable test would be useful to reduce the considerable resources required for PSG.

Methods

We developed a new mathematical analysis, which quantifies amplitude variations of pulse oximetry (SpO2) and heart rate (HR) throughout the night, allowing measurement of the total time in which ΔSpO2 >4% and presented as a new oximetric index ventilatory hypoxemic index (VHI). VHI was compared prospectively with standard PSG parameters apnea–hypopnea index (AHI) and oxygen desaturation index (ODI) in 106 patients (aged, 57 ± 14 years; BMI, 29 ± 5 kg/m2) suspected of having SAS. The criterion for diagnosis of SAS was AHI >15/h of sleep during PSG. The relationship between ΔSpO2 and ΔΗR was also investigated.

Results

We observed a significant correlation between the AHI and VHI (R = 0.87, p < 0.0001). Using VHI >15 as the criterion for SpO2, oximetry had a sensitivity of 81%, specificity of 98%, positive predictive value (PPV) of 98%, and negative predictive value (NPV) of 84% as a screening test for SAS. We also observed a clear linear relationship between ΔSpO2 and ΔΗR, and concomitant use of VHI and the ΔSpO2/ΔHR slope improved the NPV to 90%.

Conclusions

The present findings from wavelet-aggregate processing of oximeter data and the relationship between ΔSpO2 and ΔΗR show promise as a useful summary prediction of screening SAS.

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Acknowledgments

Prof. Michael David Goldman passed away on March 18, 2010. He was a forerunner in physiology research: pulmonary physiology, noninvasive monitoring of respiratory, forced oscillation technique for assessing respiratory mechanics. Michael was a friend, a mentor and we will perpetuate his memory by continuing his work.

Conflict of interest

Laurent Poupard is employed by Novacor, which is a company specialized in ambulatory recording such as Holter ECG or ambulatory blood pressure monitoring. The subject of the paper is not included in any Novacor device. Other authors have declared no conflict of interest.

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Authors and Affiliations

  1. Novacor SA, 4 passage Saint Antoine, 92500, Rueil-Malmaison, France

    Laurent Poupard

  2. Service de Physiologie-Explorations Fonctionnelles, Hopital Tenon, AP-HP, Paris, France

    Carole Philippe

  3. Laboratoire d’Explorations Fonctionnelles, Hopital Robert Ballanger, Villepinte, France

    Richard Sartène & Marc Mathieu

  4. College of Health Sciences, University of Texas, El Paso, TX, USA

    Michael David Goldman

Authors
  1. Laurent Poupard
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  2. Carole Philippe
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  3. Michael David Goldman
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  4. Richard Sartène
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  5. Marc Mathieu
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Corresponding author

Correspondence to Laurent Poupard.

Additional information

Prof. Michael David Goldman is deceased.

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Poupard, L., Philippe, C., Goldman, M.D. et al. Novel mathematical processing method of nocturnal oximetry for screening patients with suspected sleep apnoea syndrome. Sleep Breath 16, 419–425 (2012). https://doi.org/10.1007/s11325-011-0518-9

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  • DOI: https://doi.org/10.1007/s11325-011-0518-9

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