Validation a portable monitoring device for sleep apnea diagnosis in a population based cohort using synchronized home polysomnography.
OBJECTIVE
To assess the accuracy of a portable monitoring device based on peripheral arterial tonometry to diagnose obstructive sleep apnea (OSA). To propose a new standard for limited-channel device validation using synchronized polysomnography (PSG) home recordings and a population-based cohort.


METHODS
Single-night, unattended PSG and Watch_PAT 100 (WP_100).


METHODS
Home environment.


METHODS
Ninety-eight subjects (55 men; age, 60 +/- 7 year; body mass index, 28 +/- 4 kg/m2) consecutively recruited from the Skaraborg Hypertension and Diabetes Project.


RESULTS
The WP_100 records peripheral arterial tone, heart rate, oxygen saturation and actigraphy for automatic analysis of respiratory disturbance index (RDI), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and sleep-wake state. The accuracy of WP_100 in RDI, AHI, ODI, and sleep-wake detection was assessed by comparison with data from simultaneous PSG recordings. The mean PSG-AHI in this population was 25.5 +/- 22.9 events per hour. The WP_100 RDI, AHI, and ODI correlated closely (0.88, 0.90, and 0.92; p < .0001, respectively) with the corresponding indexes obtained by PSG. The areas under the curve for the receiver-operator characteristic curves for WP_100 AHI and RDI were 0.93 and 0.90 for the PSG-AHI and RDI thresholds 10 and 20 (p < .0001, respectively). The agreement of the sleep-wake assessment based on 30-second bins between the 2 systems was 82 +/- 7%.


CONCLUSIONS
The WP_100 was reasonably accurate for unattended home diagnosis of OSA in a population sample not preselected for OSA symptoms. The current design, including simultaneous home PSG recordings in population-based cohorts, is proposed as a reasonable validation standard for assessment of simplified recording tools for OSA diagnosis.
Zou
Ding
D
Sleep Laboratory, Department of Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Grote
Ludger
L
Peker
Yüksel
Y
Lindblad
Ulf
U
Hedner
Jan
J
D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000295:instrumentation*; D011159:Population Surveillance / Q000379:methods; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires