title: In-hospital diagnosis of sleep apnea in stroke patients using a portable acoustic device.
abstract: OBJECTIVE
  Sleep apnea (SA) is highly prevalent in post-stroke patients. Due to physical disability and relative inaccessibility of polysomnography (PSG) to test for SA, patients with stroke frequently remain undiagnosed and untreated. Portable SA monitoring can facilitate at-home or in-hospital testing for SA. However, portable SA monitoring is not recommended in those with complex medical conditions, such as stroke, due to the lack of validation of portable monitoring in such patients.
  
  
  METHODS
  The objective of our study was to test the accuracy and feasibility of a portable single-channel acoustic device, BresoDx™ for quantifying the apnea-hypopnea index (AHI) and diagnosing SA in a post-stroke population. Patients who recently suffered a stroke and were undergoing rehabilitation in a stroke rehabilitation unit (SRU) underwent testing with BresoDx both simultaneously during attended PSG and unattended on the SRU.
  
  
  RESULTS
  We studied 23 stroke patients of whom 78% had SA (defined by AHI ≥15) on PSG. All of the patients tolerated the BresoDx. Using cutoff AHI of ≥15 by PSG to diagnose SA, BresoDx had sensitivity of 90.0%, specificity of 84.6%, and overall accuracy of 87.0% in the laboratory.
  
  
  CONCLUSIONS
  This study demonstrates that BresoDx is well tolerated and feasible to use in the post-stroke population where it was found to have excellent positive and negative predictive values for the diagnosis of SA.
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada. clodagh.ryan@uhn.ca.|University Health Network, Toronto, ON, Canada. clodagh.ryan@uhn.ca.|Sleep Research Laboratory of the Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. clodagh.ryan@uhn.ca.|Centre for Sleep Health and Research, Toronto General Hospital, 9N-967 585 University Avenue, Toronto, ON, M5G2N2, Canada. clodagh.ryan@uhn.ca.
authors.forename: Clodagh M
authors.identifier: http://orcid.org/0000-0002-2372-965X
authors.initials: CM
authors.lastname: Ryan
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Kelly
authors.initials: K
authors.lastname: Wilton
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada.|University Health Network, Toronto, ON, Canada.|Sleep Research Laboratory of the Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
authors.forename: T Douglas
authors.initials: TD
authors.lastname: Bradley
authors.affiliation: Sleep Research Laboratory of the Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
authors.forename: Hisham
authors.initials: H
authors.lastname: Alshaer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067716:Point-of-Care Testing; D017286:Polysomnography / Q000295:instrumentation*; D015203:Reproducibility of Results; D012891:Sleep Apnea Syndromes / Q000175:diagnosis*; D020521:Stroke / Q000175:diagnosis*; D000071939:Stroke Rehabilitation / Q000295:instrumentation
keywords: Home sleep testing; Polygraphy; Sleep apnea; Stroke