Reliability of a Holter-based methodology for evaluation of sleep apnoea syndrome.
OBJECTIVE
Sleep apnoea has significant medical implications. A reliable non-invasive method (as a regular Holter system with a specific software) would be valuable for the screening of this condition in ambulatory patients.


RESULTS
A total of 40 patients were divided into two groups: Group I, 20 patients with clinical suspicion of obstructive sleep apnoea (OSA) and Epworth sleepiness score >or= 10 and Group II, 20 controls. In Group I, polysomnography was performed simultaneously with Holter (specific software to detect sleep apnoea). In Group II, Holter-based detection was utilized. A cutoff value of 10 for the apnoea-hypopnoea index (for polysomnography) or for the respiratory disturbance index (RDI) (for Holter) was considered abnormal. Sleep apnoea was confirmed by polysomnography in 14 patients (70%) in Group I. Holter recordings correctly identified OSA in 11 patients (r = 0.74 with polysomnography; P = 0.0002). Holter showed 78.5% sensitivity, 83.3% specificity, 91.6% positive predictive value, and 62.5% negative predictive value (with polysomnography as the gold standard). The RDI measured by Holter was 19.5 +/- 20 in Group I and 3.9 +/- 4.4 in controls (P < 0.005). The measurement between Holter and polysomnography (Bland and Altman method) showed good correlation (mean 4.7 with 39.4 and -30.1 SD) and a Pearson correlation coefficient (r) of 0.74 (P = 0.0002, 95% CI: 0.44-0.89).


CONCLUSIONS
Holter-based software may constitute an accessible tool on initial suspicion of OSA.
Szyszko
Ariel
A
Service of Arrhythmias and Electrophysiology, Instituto Argentino de Diagnostico y Tratamiento, Marcelo T. de Alvear 2346, 1122 Buenos Aires, Argentina. aes1974@gmail.com
Franceschini
Carlos
C
Gonzalez-Zuelgaray
Jorge
J
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012891:Sleep Apnea Syndromes / Q000175:diagnosis*