The Ignored Parameter in the Diagnosis of Obstructive Sleep Apnea Syndrome The Oxygen Desaturation Index

Temirbekoy, Destan; Güneş, Selçuk; Yazıcı, Zahide Mine; Sayın, İbrahim

doi:10.5152/tao.2018.3025

Cited by 63 publications

(39 citation statements)

References 16 publications

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“…Continuous single-channel ECG recordings could, therefore, deliver valuable information complementary to the current clinical follow-up routine for patients already diagnosed with SAS. Indeed, HRV features showed significant performance for the prediction of ODI as reported elsewhere [35]. As has been shown by others [36], our algorithm demonstrated a poor classification performance with regard to daytime sleepiness as measured by the ESS.…”

Section: Discussionsupporting

confidence: 78%

Classification of Sleep Apnea Severity by Electrocardiogram Monitoring Using a Novel Wearable Device

Baty

Boesch

Widmer

et al. 2020

Sensors

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Sleep apnea (SA) is a prevalent disorder diagnosed by polysomnography (PSG) based on the number of apnea–hypopnea events per hour of sleep (apnea–hypopnea index, AHI). PSG is expensive and technically complex; therefore, its use is rather limited to the initial diagnostic phase and simpler devices are required for long-term follow-up. The validity of single-parameter wearable devices for the assessment of sleep apnea severity is still debated. In this context, a wearable electrocardiogram (ECG) acquisition system (ECG belt) was developed and its suitability for the classification of sleep apnea severity was investigated using heart rate variability analysis with or without data pre-filtering. Several classification algorithms were compared and support vector machine was preferred due to its simplicity and overall performance. Whole-night ECG signals from 241 patients with a suspicion of sleep apnea were recorded using both the ECG belt and patched ECG during PSG recordings. 65% of patients had an obstructive sleep apnea and the median AHI was 21 [IQR: 7–40] h − 1 . The classification accuracy obtained from the ECG belt (accuracy: 72%, sensitivity: 70%, specificity: 74%) was comparable to the patched ECG (accuracy: 74%, sensitivity: 88%, specificity: 61%). The highest classification accuracy was obtained for the discrimination between individuals with no or mild SA vs. moderate to severe SA. In conclusion, the ECG belt provided signals comparable to patched ECG and could be used for the assessment of sleep apnea severity, especially during follow-up.

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Section: Discussionsupporting

confidence: 78%

Classification of Sleep Apnea Severity by Electrocardiogram Monitoring Using a Novel Wearable Device

Baty

Boesch

Widmer

et al. 2020

Sensors

View full text Add to dashboard Cite

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“…Significant differences in the severity of OSA have been described between patients with a similar AHI [22]. Nocturnal oxygen desaturations are the result of apneas and are important in the pathogenesis and development of complications of OSA [23]. The arterial oxygen desaturation index (ODI) has therefore been proposed as an alternative for the AHI in grading PSG data and classifying OSA severity [23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

“…Nocturnal oxygen desaturations are the result of apneas and are important in the pathogenesis and development of complications of OSA [23]. The arterial oxygen desaturation index (ODI) has therefore been proposed as an alternative for the AHI in grading PSG data and classifying OSA severity [23][24][25][26]. The ODI might be more relevant due to the higher reproducibility in the clinical setting [3,[19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Prediction of obstructive sleep apnea: comparative performance of three screening instruments on the apnea-hypopnea index and the oxygen desaturation index

et al. 2020

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Purpose To evaluate the performance of the NoSAS (neck, obesity, snoring, age, sex) score, the STOP-Bang (snoring, tiredness, observed apneas, blood pressure, body mass index, age, neck circumference, gender) questionnaire, and the Epworth sleepiness score (ESS) as a screening tool for obstructive sleep apnea (OSA) severity based on the apnea-hypopnea index (AHI) and the oxygen desaturation index (ODI). Methods Data from 235 patients who were monitored by ambulant polysomnography (PSG) were retrospectively analyzed. OSA severity was classified based on the AHI; similar classification categories were made based on the ODI. Discrimination was assessed by the area under the curve (AUC), while predictive parameters were calculated by four-grid contingency tables. Results The NoSAS score and the STOP-Bang questionnaire were both equally adequate screening tools for the AHI and the ODI with AUC ranging from 0.695 to 0.767 and 0.684 to 0.767, respectively. Both questionnaires perform better when used as a continuous variable. The ESS did not show adequate discrimination for screening for OSA (AUC ranging from 0.450 to 0.525). Male gender, age, and BMI proved to be the strongest individual predictors in this cohort. Conclusion This is the first study to evaluate the predictive performance of three different screening instruments with respect to both the AHI and the ODI. This is important, due to increasing evidence that the ODI may have a higher reproducibility in the clinical setting. The NoSAS score and the STOP-Bang questionnaire proved to be equally adequate to predict OSA severity based on both the AHI and the ODI.

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“…AHI is not always sufficient to assess OSA severity. Considering the contribution of nocturnal hypoxia for mortality in OSA, ODI has an importance as a prognostic value in OSA patients 22,23 . Discrepancies between AHI and other parameters such as ODI are unclear 24 .…”

Section: Discussionmentioning

confidence: 99%

Does nesfatin-1 influence the hypothalamic–pituitary–gonadal axis in adult males with obstructive sleep apnoea?

Batura‐Gabryel

Bromińska

Sawicka‐Gutaj

et al. 2019

Sci Rep

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There is growing evidence that obstructive sleep apnoea (OSA) influences the hypothalamic–pituitary–gonadal axis (HPG axis) in men. The aim of the study was to assess the association of nesfatin-1 with HPG axis disturbances in OSA. This is a prospective study with consecutive enrolment. It comprises 72 newly diagnosed OSA patients ((AHI: apnoea-hypopnea index) 18 subjects: 5 ≤ AHI < 15; 24: 15 ≤ AHI < 30; 30: AHI ≥ 30) and a control group composed of 19 patients (AHI < 5). All patients underwent polysomnography and fasting blood collection for nesfatin-1, testosterone, luteinising hormone (LH), high-sensitivity C-reactive protein (hsCRP), aspartate transaminase (AST), alanine aminotransferase (ALT), creatinine and glucose. Groups had similar levels of LH, nesfatin-1 and testosterone (p = 0.87; p = 0.24; p = 0.08). Nesfatin-1 was not correlated to LH (p = 0.71), testosterone (p = 0.38), AHI (p = 0.34) or the oxygen desaturation index (ODI) (p = 0.69) either in the whole group, or in sub-groups. The study did not reveal any association between the HPG axis and nesfatin-1 in OSA adult males. It is possible that nesfatin-1 is not a mediator of HPG axis disturbances in adult patients with OSA.

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The Ignored Parameter in the Diagnosis of Obstructive Sleep Apnea Syndrome The Oxygen Desaturation Index

Abstract: The subjective symptoms of sleep apnea syndrome seem to be closely related to oxygen desaturations. Hypoxia during apnea periods of OSA is important; therefore, we suggest that ODI is as valuable as AHI in diagnosing and grading the OSAS.

Cited by 63 publications

References 16 publications

Classification of Sleep Apnea Severity by Electrocardiogram Monitoring Using a Novel Wearable Device

Classification of Sleep Apnea Severity by Electrocardiogram Monitoring Using a Novel Wearable Device

Prediction of obstructive sleep apnea: comparative performance of three screening instruments on the apnea-hypopnea index and the oxygen desaturation index

Does nesfatin-1 influence the hypothalamic–pituitary–gonadal axis in adult males with obstructive sleep apnoea?

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