title: Detection of upper airway status and respiratory events by a current generation positive airway pressure device.
abstract: OBJECTIVE
  To compare a positive airway pressure (PAP) device's detection of respiratory events and airway status during device-detected apneas with events scored on simultaneous polysomnography (PSG).
  
  
  METHODS
  Prospective PSGs of patients with sleep apnea using a new-generation PAP device.
  
  
  METHODS
  Four clinical and academic sleep centers.
  
  
  METHODS
  Forty-five patients with obstructive sleep apnea (OSA) and complex sleep apnea (Comp SA) performed a PSG on PAP levels adjusted to induce respiratory events.
  
  
  METHODS
  None.
  
  
  RESULTS
  PAP device data identifying the type of respiratory event and whether the airway during a device-detected apnea was open or obstructed were compared to time-synced, manually scored respiratory events on simultaneous PSG recording. Intraclass correlation coefficients between device-detected and PSG scored events were 0.854 for apnea-hypopnea index (AHI), 0.783 for apnea index, 0.252 for hypopnea index, and 0.098 for respiratory event-related arousals index. At a device AHI (AHIFlow) of 10 events/h, area under the receiver operating characteristic curve was 0.98, with sensitivity 0.92 and specificity 0.84. AHIFlow tended to overestimate AHI on PSG at values less than 10 events/h. The device detected that the airway was obstructed in 87.4% of manually scored obstructive apneas. Of the device-detected apneas with clear airway, a minority (15.8%) were manually scored as obstructive apneas.
  
  
  CONCLUSIONS
  A device-detected apnea-hypopnea index (AHIFlow) < 10 events/h on a positive airway pressure device is strong evidence of good treatment efficacy. Device-detected airway status agrees closely with the presumed airway status during polysomnography scored events, but should not be equated with a specific type of respiratory event.
authors.affiliation: Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Qing Yun
authors.initials: QY
authors.lastname: Li
authors.affiliation: Department of Medicine, University of Florida, Gainesville, FL.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Berry
authors.affiliation: Bronson Sleep Health, Kalamazoo, MI.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Goetting
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Bethany
authors.initials: B
authors.lastname: Staley
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Haideliza
authors.initials: H
authors.lastname: Soto-Calderon
authors.affiliation: Department of Medicine, National Jewish Health, Denver, CO.
authors.forename: Sheila C
authors.initials: SC
authors.lastname: Tsai
authors.affiliation: Philips Respironics, Inc., Monroeville, PA.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Jasko
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Allan I
authors.initials: AI
authors.lastname: Pack
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.|Department of Medicine, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA.
authors.forename: Samuel T
authors.initials: ST
authors.lastname: Kuna
mesh_terms: D001143:Arousal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D012372:ROC Curve; D012119:Respiration; D012137:Respiratory System / Q000033:anatomy & histology / Q000503:physiopathology*; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000503:physiopathology*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology*
keywords: central sleep apnea; obstructive sleep apnea; positive airway pressure; respiratory event related arousal; upper airway