Oximetry Alone Versus Portable Polygraphy for Sleep Apnea Screening Before Bariatric Surgery

Malbois, Maude; Giusti, Vittorio; Suter, Michel; Pellaton, Cyril; Vodoz, Jean-Frédéric; Heinzer, Raphaël

doi:10.1007/s11695-009-0055-9

Cited by 37 publications

(23 citation statements)

References 20 publications

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“…However, there is a lack of studies evaluating the effectiveness of unattended oximetry at patient's home in the presence of comorbidities. Some works have been carried out, particularly in stroke patients [44] and patients with heart failure [45] or arterial hypertension [46]; in the presence of morbid obesity [47] or chronic obstructive pulmonary disease (COPD) [23,48]; in patients remitted for surgery [49]; or in frail hospitalized elderly patients [50]. Table 4 summarizes the main characteristics of studies using oximetry to assist in OSAS diagnosis in patients with comorbidities.…”

Section: Portable Oximetry In Osas Patients With Comorbidities and Spmentioning

confidence: 99%

“…Malbois et al [47] used oximetry alone as abbreviated screening test for OSAS in morbid obese patients before bariatric surgery. Focusing on severe OSAS patients (AHI ≥30 events/h), the authors reported 100% sensitivity and 93% specificity using the conventional ODI3 obtained via unsupervised polygraphy at home (type III portable monitoring).…”

Section: Portable Oximetry In Osas Patients With Comorbidities and Spmentioning

confidence: 99%

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Oximetry use in obstructive sleep apnea

Campo

Crespo

Cerezo-Hernández

et al. 2018

Expert Review of Respiratory Medicine

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Introduction. Overnight oximetry has been proposed as an accessible, simple, and reliable technique for obstructive sleep apnea syndrome (OSAS) diagnosis. From visual inspection to advanced signal processing, several studies have demonstrated the usefulness of oximetry as a screening tool. However, there is still controversy regarding the general application of oximetry as a single screening methodology for OSAS.Areas covered. Currently, high-resolution portable devices combined with pattern recognitionbased applications are able to achieve high performance in the detection this disease. In this review, recent studies involving automated analysis of oximetry by means of advanced signal processing and machine learning algorithms are analyzed. Advantages and limitations are highlighted and novel research lines aimed at improving the screening ability of oximetry are proposed. Expert commentary. Oximetry is a cost-effective tool for OSAS screening in patients showinghigh pretest probability for the disease. Nevertheless, exhaustive analyses are still needed to further assess unattended oximetry monitoring as a single diagnostic test for sleep apnea, particularly in the pediatric population and in especial groups with significant comorbidities. In the following years, communication technologies and big data analysis will overcome current limitations of simplified sleep testing approaches, changing the detection and management of OSAS.

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Section: Portable Oximetry In Osas Patients With Comorbidities and Spmentioning

confidence: 99%

Section: Portable Oximetry In Osas Patients With Comorbidities and Spmentioning

confidence: 99%

Oximetry use in obstructive sleep apnea

Campo

Crespo

Cerezo-Hernández

et al. 2018

Expert Review of Respiratory Medicine

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“…Malbois et al compared the sensitivity of nocturnal oximetry to ambulatory monitoring in order to identify patients with sleep apnea prior to undergoing bariatric surgery. 115 They demonstrated that nocturnal oximetry with a 3% desaturation index as a screening tool for OSA could rule out significant OSA (AHI > 10) and also detect patients with severe OSA. This cheap and widely available technique could accelerate preoperative work-up of these patients.…”

Section: Nocturnal Pulse Oximetrymentioning

confidence: 99%

Obstructive Sleep Apnea Syndrome and Perioperative Complications: A Systematic Review of the Literature

Vasu

Grewal

Doghramji

2012

Journal of Clinical Sleep Medicine

217

147

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Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder. Its prevalence is estimated to be between 2% and 25% in the general population. However, the prevalence of sleep apnea is much higher in patients undergoing elective surgery. Sedation and anesthesia have been shown to increase the upper airway collapsibility and therefore increasing the risk of having postoperative complications in these patients. Furthermore, the majority of patients with sleep apnea are undiagnosed and therefore are at risk during the perioperative period. It is important to identify these patients so that appropriate actions can be taken in a timely fashion. In this review article, we will discuss the epidemiology of sleep apnea in the surgical population. We will also discuss why these patients are at a higher risk of having postoperative complications, with the special emphasis on the role of anesthesia, opioids, sedation, and the phenomenon of REM sleep rebound. We will also review how to identify these patients preoperatively and the steps that can be taken for their perioperative management. OSAS has been shown to be associated with various healthrelated consequences, including increased rate of motor vehicle accidents, hypertension, diabetes mellitus, congestive heart failure, stroke, and all-cause mortality. [1][2][3][4][5][6][7][8][9] Recently, numerous studies have demonstrated that surgical patients with sleep apnea are at increased risk of having perioperative complications, including hypoxemia, pneumonia, diffi cult intubation, myocardial infarction, pulmonary embolism, atelectasis, cardiac arrhythmias, and unanticipated admission to the ICU. The majority of patients with OSA are undiagnosed upon admission and are at risk during the perioperative period, presumably due to their underlying sleep apnea. Therefore, it is very important to identify these patients preoperatively so that one can initiate appropriate perioperative measures. EpidemiologyOSAS is an extremely common sleep related breathing disorder, and its prevalence has been increasing throughout the world because of obesity and increasing age of the general population. Its prevalence is between 2% and 25% in the general population, depending upon how sleep apnea is defi ned. In an epidemiological study, Young et al. noted that the prevalence of sleep apnea, defi ned as apnea-hypopnea index (AHI) ≥ 5/h was 9% for women and 24% for men. 10 However, the prevalence of OSAS (defi ned as AHI ≥ 5/h and daytime sleepiness) was 2% in women and 4% in men. 10 The National Sleep Foundation (NSF) Sleep in America 2005Poll found that 1 in 4 Americans are at high risk of having sleep apnea based on the Berlin Questionnaire. 11 The prevalence of sleep apnea is much higher in surgical patients and depends on the type of surgery. In the bariatric surgery population, the prevalence of sleep apnea has been found to be > 70%. 12,13 It is the standard of care for these patients to get a formal sleep evaluation prior to undergoing the bariatric surgery. Howev...

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“…Bariatrik cerrahi öncesi, OSA'lı hastaları belirlemede noktürnal oksimetri ve ambulatuvar monitörizasyonun sensitivitesinin karşılaştırıldığı bir çalışmada noktürnal oksimetride %3'lük desatü-rasyon indeksi ile OSA'nın belirlenmesini sağlayan araçlar arasında ucuz ve yaygın ulaşılabilir; hastaların preoperatif değer-lendirmesinde kullanılabilecek bir yöntem olduğu gösterilmiş-tir. [68].…”

Section: Noktürnal Puls Oksimetriunclassified

The Evaluation and Management of Sleep Disordered Breathing During Perioperative Period

Kıvanç¹

2015

Ann Clin Anal Med

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ÖzetObstrüktif uyku apne (OSA), uyku sırasında arteriyel oksijen satürasyonun-da azalma, tekrarlayan üst solunum yolu tıkanıklıkları, sempatik tonusta artış ve tekrarlayan uyanıklıklarla karakterize bir sendromdur. OSA, en sık görülen uyku ile ilişkili solunum bozukluğudur. Amerika Birleşik Devletlerde (ABD) orta yaşlı nüfusun erkeklerde %4 ve kadınlarda %2'sinde rastlanır. Buna rağmen hastaların önemli bir kısmı tanı almamış ve tedavi edilmemiştir. Tüm bu bulgular cerrahi işleme alınan OSA'lı olguların da önemli bölümünün tanı almadı-ğını açıkça göstermektedir. Bu nedenle hekimler yaygın görülen bu hastalığın işlem öncesi hızla tanınması için tarama yapmalı, böylelikle de uykuda solunum bozukluklarının neden olacağı anestezi riskinden hastalarını korumalı ve gerekli tedavi yöntemlerini uygulamalıdırlar. Anahtar KelimelerUykuda Solunum Bozukluğu; Obstrüktif Uyku Apne Sendromu; Perioperatif Değerlendirme Abstract Obstructive sleep apnea (OSA) is a syndrome defined frequently by decrease in arterial oxygen saturation, repeated upper airway obstruction episodes, increases in sympathetic output and tone, and repetitive arousals during sleep. OSA is the most common form of sleep-disordered breathing. In the United States, it has been estimated that 4% of middle aged males and 2% of middle aged females have OSA. Nevertheless the majority of patients who affect from OSA are undiagnosed and untreated. All these evidences imply that a prominent portion of OSA patients who undergo surgery will not be diagnosed and that the physicians must screen patients suspected of having sleep-disordered breathing to customize the anesthetic care and start necessary evaluations and therapy.

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Oximetry Alone Versus Portable Polygraphy for Sleep Apnea Screening Before Bariatric Surgery

Abstract: Using oximetry with 3% desaturation index as a screening tool for OSA could allow us to rule out significant OSA in almost a third of the patients and to detect patients with severe OSA. This cheap and widely available technique could accelerate preoperative work-up of these patients.

Cited by 37 publications

References 20 publications

Oximetry use in obstructive sleep apnea

Oximetry use in obstructive sleep apnea

Obstructive Sleep Apnea Syndrome and Perioperative Complications: A Systematic Review of the Literature

The Evaluation and Management of Sleep Disordered Breathing During Perioperative Period

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