Validation of ApneaLink Ox™ for the diagnosis of obstructive sleep apnea

Nigro, Carlos; Dibur, Eduardo; Malnis, Silvana; Grandval, Sofía; Nogueira, Facundo

doi:10.1007/s11325-012-0684-4

Cited by 55 publications

(46 citation statements)

References 30 publications

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“…ApneaLink was used to collect data regarding SDB since it is a validated, 18,19,44 feasible tool that is easy to use for elderly patients in home-based settings. However, limitations include that it is not extensively used in CHF studies, and it lacks the possibility to distinguish between obstructive and central sleep apnoea, as well as determine sleep onset and awakenings.…”

Section: Discussionmentioning

confidence: 99%

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Association between sleep‐disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure

Hjelm

Strömberg

Årestedt

et al. 2013

European J of Heart Fail

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AimsChronic heart failure (CHF) and sleep-disordered breathing (SDB) are often co-existing problems among the elderly. Apnoeic events may cause cognitive impairment. The aim of the study was to compare sleep and wake patterns, insomnia, daytime sleepiness, and cognitive function in community-dwelling CHF patients, with and without SDB, and to investigate the association between sleep-related factors and cognitive dysfunction. Methods and resultsIn this cross-sectional observational study, SDB was measured with an ApneaLink device and defined as an apnoeahypopnoea index (AHI) ≥15/h of sleep. Sleep and wake patterns were measured with actigraphy for 1 week. Insomnia was measured with the Minimal Insomnia Symptom Scale, daytime sleepiness with the Epworth Sleepiness Scale, and cognitive function with a neuropsychological test battery. A total of 137 patients (68% male, median age 72 years, 58% NYHA functional class II) were consecutively included. Forty-four per cent had SDB (AHI ≥15). The SDB group had significantly higher saturation time below 90%, more difficulties maintaining sleep, and lower levels of daytime sleepiness compared with the non-SDB group. Cognitive function and sleep and wake patterns did not differ between the SDB and the non-SDB group. Insomnia was associated with decreased global cognition. ConclusionThe prevalence of cognitive dysfunction was low in this population with predominantly mild to moderate CHF. This might have influenced the lack of associations between cognitive function and SDB. Insomnia was the only sleep-related factor significantly influencing cognition.--

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Section: Discussionmentioning

confidence: 99%

“…Validation of the ApneaLink demonstrates that the device provides reliable information regarding AHI, when compared with a full polysomnography. 18,19 SDB was dichotomized into two groups; no SDB (AHI ,15/h of sleep) and SDB (AHI ≥15/h of sleep).…”

Section: Sleep-disordered Breathingmentioning

confidence: 99%

Association between sleep‐disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure

Hjelm

Strömberg

Årestedt

et al. 2013

European J of Heart Fail

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“…Details of linearization of the nasal pressure signal and processing of artifact in the pulse oximetry signal have been outlined in past validation studies. 16,17,20,21 Initial PM data analysis was automated (by ApneaLink software) with rules defined to match laboratory PSG settings. 22 Manual data review used the PSG data analysis platform after importing ApneaLink signals (EDF format with removal of automated results).…”

Section: Portable Study (Pm Study)mentioning

confidence: 99%

“…Previous studies have one or more of the following limitations: (a) failure to study the PM device in its site of intended use, the home 18,19,27,28 ; (b) low sample size [16][17][18][19][20][21]27,28 ; (c) failure to collect oximetry data [16][17][18][19][20]27,29 ; (d) no randomization of order of comparison 18,19,27,28 ; and (d) no manual review of the raw PM data. [16][17][18][19][20]27,29,30 Our validation addresses these limitations.…”

Section: -11mentioning

confidence: 99%

A Comprehensive Evaluation of a Two-Channel Portable Monitor to “Rule in” Obstructive Sleep Apnea

Ward

McArdle

Bremner

et al. 2015

Journal of Clinical Sleep Medicine

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Study Objectives:We hypothesized that a dual-channel portable monitor (PM) device could accurately identify patients who have a high pretest probability of obstructive sleep apnea (OSA), and we evaluated factors that may contribute to variability between PM and polysomnography (PSG) results. Methods: Consecutive clinic patients (N = 104) with possible OSA completed a home PM study, a PM study simultaneous with laboratory PSG, and a second home PM study. Uniform data analysis methods were applied to both PM and PSG data. Primary outcomes of interest were the positive likelihood ratio (LR+) and sensitivity of the PM device to "rule-in" OSA, defi ned as an apnea-hypopnea index (AHI) ≥ 5 events/h on PSG. Effects of different test environment and study nights, and order of study and analysis methods (manual compared to automated) on PM diagnostic accuracy were assessed. Results: The PM has adequate LR+ (4.8), sensitivity (80%), and specifi city (83%) for detecting OSA in the unattended home setting when benchmarked against laboratory PSG, with better LR+ (> 5) and specifi city (100%) and unchanged sensitivity (80%) in the simultaneous laboratory comparison. There were no signifi cant night-night (all p > 0.10) or study order effects (home or laboratory fi rst, p = 0.08) on AHI measures. Manual PM data review improved case fi nding accuracy, although this was not statistically signifi cant (all p > 0.07). Misclassifi cation was more frequent where OSA was mild. Conclusions: Overall performance of the PM device is consistent with current recommended criteria for an "acceptable" device to confi dently "rule-in" OSA (AHI ≥ 5 events/h) in a high pretest probability clinic population. Our data support the utility of simple two-channel diagnostic devices to confi rm the diagnosis of OSA in the home environment.

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“…An idea of the entrenched positions can be found in recent issues of Sleep [3][4][5] and the Journal of Clinical Sleep Medicine [6]. With all the interests at stake [7], the debate needs carefully conducted studies aimed at evaluating automated software, for instance for automated detection of obstructive sleep apnea [8] or for automated sleep scoring like the one presented by Stege and colleagues in this issue of Sleep and Breathing.…”

mentioning

confidence: 99%