Validation of ApneaLink as screening device for Cheyne-Stokes respiration.
OBJECTIVE
Polysomnography (PSG) is the gold standard in diagnosing sleep disordered breathing (SDB). Diagnostic analysis of SDB is time-consuming and labor-intensive and entails long waiting lists for patients. The aim of this study was to assess the validity of a flow-based screening classifier as an automated diagnostic test for Cheyne-Stokes respiration (CSR).


METHODS
Sleep laboratory.


METHODS
70 study subjects (28 with obstructive sleep apnea [OSA], 20 with CSR, 11 with CSR+OSA and 11 without SDB).


METHODS
The nasal cannula flow signal was analyzed by ApneaLink (ResMed, Sydney, Australia), based on a classifier algorithm using pattern recognition. In a simultaneous PSG, results were compared with manual scoring of respiratory events by certified sleep experts.


RESULTS
For detecting CSR we obtained a sensitivity of 87.1% (95% confidence interval 75.3% to 98.9%), a specificity of 94.9% (95% confidence interval 87.9% to 100%), a positive likelihood ratio of 17.0, and a negative likelihood ratio of 0.14. The area under the curve (AUC) of the according receiver operating characteristic (ROC) curve was 93.4%. This resulted in an accuracy of 91.4% for identifying CSR.


CONCLUSIONS
In this study we demonstrated that the screening classifier was able to detect CSR with high diagnostic accuracy. Hence, ApneaLink equipped with CSR classifier is an appropriate screening tool which may help to prioritize patients with CSR for PSG.
Weinreich
Gerhard
G
Ruhrlandklinik, Department of Respiratory Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany. gerhard.weinreich@uni-due.de
Armitstead
Jeff
J
Töpfer
Volker
V
Wang
You-Ming
YM
Wang
Yi
Y
Teschler
Helmut
H
D000368:Aged; D002639:Cheyne-Stokes Respiration / Q000175:diagnosis* / Q000503:physiopathology; D015897:Comorbidity; D004867:Equipment Design; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D008297:Male; D008365:Manometry / Q000295:instrumentation*; D008403:Mass Screening / Q000295:instrumentation*; D008875:Middle Aged; D016571:Neural Networks, Computer; D009666:Nose; D017286:Polysomnography / Q000295:instrumentation*; D012123:Pulmonary Ventilation / Q000502:physiology*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology; D014160:Transducers, Pressure