Pragmatic Validation of Home Portable Sleep Monitor for diagnosing Obstructive Sleep Apnea in a non-referred population: The ELSA-Brasil study

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Arquivos
art_AIELO_Pragmatic_Validation_of_Home_Portable_Sleep_Monitor_for_2019.PDF (607.76 KB)
Citações na Scopus
21
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
Título da Revista
ISSN da Revista
Título do Volume
Editora
BRAZILIAN ASSOC SLEEP
Autores
SILVA, Wagner A.
CUNHA, Lorenna F.
Citação
SLEEP SCIENCE, v.12, n.2, p.65-71, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective: Polygraphy (PG) is an attractive alternative for diagnosing obstructive sleep apnea (OSA) in patients with high pre-test probability. However, several patients may not present typical symptoms. In this scenario, it is unclear the performance of PG for diagnosing OSA in non-referred populations to sleep laboratories. Methods: Data from participants of the ELSA-Brasil cohort were used for this analysis. We performed an overnight home PG (Embletta Gold (TM)) synchronized with a wrist actigraphy (Actiwatch model 2 (TM)). The validation strategy comprised three scorings from each participant: 1) Original scoring (PG): Routine scoring using data from the exclamation button mark to define ""analysis start"" and ""analysis stop""; 2) Scoring using actigraphy data (PG+actigraphy): total sleep time defined by the actigraphy data; 3) Scoring using diaries (PG+diary): ""analysis start"" and ""analysis stop"" based on the diaries. Bland-Altman plots were generated to assess the agreements (Kappa) between each scoring strategy. Results: A total of 300 participants were included in the final analysis (45% males, mean age: 48 +/- 8 years). The frequency of OSA using the PG score was 27.3%. Despite small differences in the OSA severity index, we obtained a high concordance of AHI comparing the PG vs. PG+actigraphy (Kappa: 0.95) as well as PG+diary vs. PG+actigraphy (Kappa: 0.96). No significant changes in the OSA classification (mild, moderate and severe) were observed in the 3 protocols. Conclusion: Using a pragmatic approach to address OSA at home, our results suggest that PG is a useful tool for OSA diagnosis even in subjects not referred to sleep studies.
Palavras-chave
Sleep Apnea, Diagnosis, Polysomnography, Wrist
URI
https://observatorio.fm.usp.br/handle/OPI/33941
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - HU
Artigos e Materiais de Revistas Científicas - LIM/20
Artigos e Materiais de Revistas Científicas - LIM/63