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Sleep. 2012 Mar 1;35(3):361-7. doi: 10.5665/sleep.1696.

Respiratory event detection by a positive airway pressure device.

Author information

1
Department of Medicine, University of Florida, Gainesville, FL 32610, USA. sleep_doc@msn.com

Abstract

STUDY OBJECTIVES:

Compare automatic event detection (AED) of respiratory events using a positive airway pressure (PAP) device with manual scoring of polysomnography (PSG) during PAP treatment of obstructive sleep apnea (OSA).

DESIGN:

Prospective PSGs of patients using a PAP device.

SETTING:

Six academic and private sleep disorders centers.

PATIENTS:

A total of 148 PSGs from 115 participants with OSA (apnea-hypopnea index [AHI] ≥ 15 events/hr) were analyzed.

INTERVENTIONS:

A signal generated by the PAP device identifying the AED of respiratory events based on airflow was recorded during PSG.

MEASUREMENTS AND RESULTS:

The PSGs were manually scored without visualization of the AED signal and scoring of a hypopnea required a ≥ 4% oxygen desaturation. The apnea index (AI), hypopnea index (HI), and AHI by manual score and PAP AED were compared. A customized computer program compared individual events by manual scoring and AED to determine the true positive, false positive, false negative, or true negative events and found a sensitivity of 0.58 and a specificity of 0.98. The AHI, AI, and HI by the two methods were highly correlated. Bland-Altman analysis showed better agreement for AI than HI. Using a manually scored AHI of ≥ 10 events/hr to denote inadequate treatment, an AED AHI ≥ 10 events/hr had a sensitivity of 0.58 and a specificity of 0.94.

CONCLUSIONS:

An AHI < 10 events/hr by PAP AED is usually associated with good treatment efficacy. Differences between manually scored and AED events were primarily due to different criteria for hypopnea detection.

KEYWORDS:

APAP; CPAP; autoCPAP

PMID:
22379242
PMCID:
PMC3274337
DOI:
10.5665/sleep.1696
[Indexed for MEDLINE]
Free PMC Article
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