Comparison between a single-channel nasal airflow device and oximetry for the diagnosis of obstructive sleep apnea.
BACKGROUND
The most common single channel devices used for obstructive sleep apnea (OSA) screening are nasal airflow and oximetry. No studies have directly compared their role in diagnosing OSA at home.


OBJECTIVE
To prospectively compare the diagnostic utility of home-based nasal airflow and oximetry to attended polysomnography (PSG) and to assess the diagnostic value of adding oximetry to nasal airflow for OSA.


METHODS
Cross-sectional study.


METHODS
Laboratory and home.


METHODS
Sleep clinic patients with suspected OSA.


METHODS
All patients had laboratory PSG and 2 sets of 3 consecutive nights on each device; nasal airflow (Flow Wizard, DiagnoselT, Australia) and oximetry (Radical Set, Masimo, USA) at home in random order.


RESULTS
Ninety-eight of the 105 patients enrolled completed home monitoring. The accuracy of nasal airflow respiratory disturbance index (NF RDI) was not different from oximetry (ODI 3%) for diagnosing OSA (area under the ROC curve (AUC) difference, 0.04; 95% CI of difference -0.05 to 0.12; P = 0.43) over 3 nights of at-home recording. The accuracy of NF RDI was higher after 3 nights compared to one night (AUC difference, 0.05; 95% CI of difference, 0.01 to 0.08; P = 0.04). Addition of oximetry to nasal airflow did not increase the accuracy for predicting OSA compared to nasal airflow alone (P > 0.1).


CONCLUSIONS
Nasal flow and oximetry have equivalent accuracy for diagnosing OSA in the home setting. Choice of device for home screening of sleep apnea may depend on logistical and service delivery issues.
Rofail
Lydia Makarie
LM
National Health Medical Research Council Centre for Clinical Research Excellence in Respiratory and Sleep Medicine, Australia. lydiamr@woolcock.org.au
Wong
Keith K H
KK
Unger
Gunnar
G
Marks
Guy B
GB
Grunstein
Ronald R
RR
D000328:Adult; D003430:Cross-Sectional Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D010092:Oximetry / Q000295:instrumentation*; D017286:Polysomnography / Q000295:instrumentation*; D025363:Rhinomanometry / Q000295:instrumentation*; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*
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