title: The Accuracy of Portable Monitoring in Diagnosing Significant Sleep Disordered Breathing in Hospitalized Patients.
abstract: BACKGROUND
  Polysomnograms are not always feasible when sleep disordered breathing (SDB) is suspected in hospitalized patients. Portable monitoring is a practical alternative; however, it has not been recommended in patients with comorbidities.
  
  
  OBJECTIVE
  We evaluated the accuracy of portable monitoring in hospitalized patients suspected of having SDB.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Large, public, urban, teaching hospital in the United States.
  
  
  METHODS
  Hospitalized patients suspected of having SDB.
  
  
  METHODS
  Patients underwent portable monitoring combined with actigraphy during the hospitalization and then polysomnography after discharge. We determined the accuracy of portable monitoring in predicting moderate to severe SDB and the agreement between the apnea hypopnea index measured by portable monitor (AHIPM) and by polysomnogram (AHIPSG).
  
  
  RESULTS
  Seventy-one symptomatic patients completed both tests. The median time between the two tests was 97 days (IQR 25-75: 24-109). Forty-five percent were hospitalized for cardiovascular disease. Mean age was 52±10 years, 41% were women, and the majority had symptoms of SDB. Based on AHIPSG, SDB was moderate in 9 patients and severe in 39. The area under the receiver operator characteristics curve for AHIPM was 0.8, and increased to 0.86 in patients without central sleep apnea; it was 0.88 in the 31 patients with hypercapnia. For predicting moderate to severe SDB, an AHIPM of 14 had a sensitivity of 90%, and an AHIPM of 36 had a specificity of 87%. The mean±SD difference between AHIPM and AHIPSG was 2±29 event/hr.
  
  
  CONCLUSIONS
  In hospitalized, symptomatic patients, portable monitoring is reasonably accurate in detecting moderate to severe SDB.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Cook County Health and Hospitals System, Chicago, Illinois, United States of America.
authors.forename: Swamy
authors.identifier: http://orcid.org/0000-0003-1501-052X
authors.initials: S
authors.lastname: Nagubadi
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Cook County Health and Hospitals System, Chicago, Illinois, United States of America.
authors.forename: Rohit
authors.initials: R
authors.lastname: Mehta
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Cook County Health and Hospitals System, Chicago, Illinois, United States of America.
authors.forename: Mamoun
authors.initials: M
authors.lastname: Abdoh
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Cook County Health and Hospitals System, Chicago, Illinois, United States of America.
authors.forename: Mohammedumer
authors.initials: M
authors.lastname: Nagori
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Cook County Health and Hospitals System, Chicago, Illinois, United States of America.
authors.forename: Stephen
authors.initials: S
authors.lastname: Littleton
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Cook County Health and Hospitals System, Chicago, Illinois, United States of America.
authors.forename: Renaud
authors.initials: R
authors.lastname: Gueret
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Cook County Health and Hospitals System, Chicago, Illinois, United States of America.
authors.forename: Aiman
authors.initials: A
authors.lastname: Tulaimat
mesh_terms: D056044:Actigraphy; D000328:Adult; D019540:Area Under Curve; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000295:instrumentation*; D011446:Prospective Studies; D012372:ROC Curve; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology