Respiratory polygraphy with actigraphy in the diagnosis of sleep apnea-hypopnea syndrome.
OBJECTIVE
To determine the utility and reliability of a respiratory polygraphy (RP) device with actigraphy (Apnoescreen II; Erich Jaeger GMBH & CoKg; Wuerzburg, Germany) in the diagnosis of sleep apnea-hypopnea syndrome (SAHS).


METHODS
A prospective randomized study with blinded analysis.


METHODS
Sixty-two patients with suspected SAHS.


METHODS
the following two RP studies were performed: one in the sleep laboratory (sleep laboratory RP [LRP]), simultaneously with polysomnography; and the other at home (home RP [HRP]). To study the interobserver reliability of RP, two manual analyses were carried out by two different researchers.


RESULTS
In LRP, when the respiratory disturbance index was calculated using the total sleep time estimated by actigraphy (RDI) as a denominator, the sensitivity ranged between 94.6% and 100%, and the specificity between 88% and 96.7% for the different cutoff points of the apnea-hypopnea indexes studied. When the respiratory disturbance index was calculated according to the total recording time (RDITRT), the sensitivity was slightly lower (91.6 to 96.9%) and the specificity was similar (92 to 96.7%). In HRP, the sensitivity of the RDI ranged between 83.8% and 95.8%, and the specificity between 92% and 100%, whereas, when the RDITRT was used, the sensitivity was between 83.8% and 87.5%, and the specificity was between 94.7% and 100%. With regard to interobserver reliability, the intraclass correlation coefficient for the RDI of the two analyses of the RP was 0.99 for both LPR and HPR.


CONCLUSIONS
HPR is an effective and reliable technique for the diagnosis of SAHS, although it is less sensitive than LRP. Wrist actigraphy improves the results of HRP only slightly.
García-Díaz
Emilio
E
Departments of Critical Care and Emergency, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain. Electronic address: emil800@separ.es.
Quintana-Gallego
Esther
E
Department of Pneumology, Hospital San Juan de Dios, Sevilla, Spain.
Ruiz
Aránzazu
A
Pneumology, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain.
Carmona-Bernal
Carmen
C
Pneumology, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain.
Sánchez-Armengol
Ángeles
Á
Pneumology, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain.
Botebol-Benhamou
Georgina
G
Neurophysiology, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain.
Capote
Francisco
F
Pneumology, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain.
D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D015588:Observer Variation; D017286:Polysomnography / Q000295:instrumentation*; D011446:Prospective Studies; D012123:Pulmonary Ventilation / Q000502:physiology*; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology; D012984:Software; D013223:Statistics as Topic