Utility of portable monitoring in the diagnosis of obstructive sleep apnea

Abstract

Obstructive sleep apnea (OSA) is a common but underdiagnosed sleep disorder, which is associated with systemic consequences such as hypertension, stroke, metabolic syndrome, and ischemic heart disease. Nocturnal laboratory-based polysomnography (PSG) is the gold standard test for diagnosis of OSA. PSG consists of a simultaneous recording of multiple physiologic parameters related to sleep and wakefulness including electroencephalography (EEG), electrooculography (EOG), surface electromyography (EMG), airflow measurement using thermistor and nasal pressure transducer, pulse oximetry and respiratory effort (thoracic and abdominal). Multiple alternative and simpler methods that record respiratory parameters alone for diagnosing OSA have been developed in the past two decades. These devices are called portable monitors (PMs) and enable performing sleep studies at a lower cost with shorter waiting times. It has been observed and reported that comprehensive sleep evaluation coupled with the use of PMs can fulfill the unmet need for diagnostic testing in various out-of-hospital settings in patients with suspected OSA. This article reviews the available medical literature on PMs in order to justify the utility of PMs in the diagnosis of OSA, especially in resource-poor, high-disease burden settings. The published practice parameters for the use of these devices have also been reviewed with respect to their relevance in the Indian setting.

Drug-induced sleep endoscopy-directed adenotonsillectomy in pediatric obstructive sleep apnea with small tonsils

“…Since the growing demand and the need for multiple sleep studies makes OSA diagnosis and management particularly challenging, parameters from PSG, which is the gold standard to diagnose OSA, was not consistently used in the children included in the present study and could not be included in the analyses. Nevertheless, the validity of CPC and nocturnal oximetry monitoring for OSA diagnosis has been reported [17, 18, 20, 21]. In addition, the study was done at a single tertiary medical center.…”

“…The nocturnal oximetry monitor (CloudCare Healthcare Co., Ltd.) has the appearance of a wrist watch and can be worn comfortably during sleep [20, 21]. The changes of oxygen saturation nadir collected from the oximetry monitor before and after upper airway surgery were compared.…”

Diagnostic Value of Sestrin2 in Patients with Obstructive Sleep Apnea

“… 28 However, some suggested that the diversity of PM devices and multiscoring schemes had a significant negative impact on the diagnostic effectiveness of OSA. 29 , 30 Moreover, questionnaires are often used to screen OSA. 5 However, OSA is often accompanied by cognitive deficits, 31 so that its accuracy is not enough to rely on.…”

<p>Watch-PAT is Useful in the Diagnosis of Sleep Apnea in Patients with Atrial Fibrillation</p>

“…Home Sleep Apnea Testing (HSAT) have been therefore developed for the detection of sleep apnea. 14 The recent COVID19 epidemic further emphasized the importance of the ability to diagnose sleep disordered breathing in the home. Many sleep labs were closed, and most studies were home based.…”