Contribution of pulse oximetry in relation to respiratory flow events in a home-based approach aimed at diagnosing obstructive sleep apnea

Abstract

Objective: To compare pulse oximetry with manual analysis against all signals of respiratory polygraphy. Material and Methods: This retrospective study estimated sensitivity (S), specificity (Sp) and positive/negative likelihood ratio (LR+/-) of the oxygen desaturation index (ODI-test) and apnea-hypopnea index (AHI-reference). Results: 3854 patients (61.5% men) were included. Age, BMI, Epworth sleepiness scale and AHI were: 55 years (44-65), 30.9kg/m2 (27-36), 7 points (4-11), and 14 events/hour (6-25), respectively. 18% showed an AHI 15 and 30. The S, Sp, and LR+/- of ODI for AHI = 5 events/hour was 93%, 92%, 12 and 0.08 with an accuracy of 93%. For AHI = 15 events/hour, the values were: S 94%, Sp 94%, LR+ 15 and LR- 0.06 and 94% accuracy (r2 Spearman: 0.92). Conclusion: In a population at a high risk for OSA, home-based pulse oximetry had a diagnostic accuracy > 90% when is compared against all respiratory signals obtained from simplified home sleep testing.

Keywords

• oximetry
• diagnosis
• sleep apnea syndrome