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Validation of ApneaLink Ox™ for the diagnosis of obstructive sleep apnea

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Abstract

Objective

The aim of the study was to validate the automatic and manual analysis of ApneaLink Ox™ (ALOX) in patients with suspected obstructive sleep apnea (OSA).

Methods

All patients with suspected OSA had a polysomnography (PSG) and an ALOX performed in the sleep laboratory. For automatic analysis, hypopnea was defined as a decrease in airflow ≥30 % of baseline for at least 10 s plus oxygen desaturation ≥3 or 4 %. While for the manual analysis, hypopnoea was considered when a reduction of airflow ≥30 % of ≥10 s plus oxygen desaturation ≥3 % or increase in cardiac rate ≥5 beats/min were identified or, when only a reduction of airflow ≥50 % was observed. OSA was defined as a respiratory disturbance index (RDI) ≥5. The apnea/hypopnea automatic index (AHI3-a, AHI4-a) and manual index were estimated. Receiver operating characteristics (ROC) analysis and the agreement between ALOX and PSG were performed.

Results

Fifty-five patients were included (38 men; mean age, 48.2; median, RDI 15.1; median BMI, 30 Kg/m2). The automatic analysis of ALOX under-estimated the RDI from PSG, mainly for the criterion of oxygen desaturation ≥4 % (AHI3-a–RDI, −3.6 ± 10.1; AHI4-a–RDI, −6.5 ± 10.9, p < 0.05). The autoscoring from ALOX device showed a better performance when it was set up to identify hypopneas with an oxygen desaturation criterion of ≥3 % than when it was configured with an oxygen desaturation criterion of ≥4 % (area under the receiver operator curves, 0.87 vs. 0.84). Also, the manual analysis was found to be better than the autoscoring set up with an oxygen desaturation of ≥3 % (0.923 vs. 0.87). The manual analysis showed a good interobserver agreement for the classification of patients with or without OSA (k = 0.81).

Conclusion

The AHI obtained automatically from the ApneaLink Ox™ using oxygen desaturation ≥3 % as a criterion of hypopnea had a good performance to diagnose OSA. The manual scoring from ApneaLink Ox™ was better than the automatic scoring to discriminate patients with OSA.

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Acknowledgments

The authors wish to thank Ms. Jaquelina Mastantuono for revising the English text.

Disclosure of financial support

None.

Disclosure of any conflicts of interest

Carlos A. Nigro received two ApneaLink Ox devices by the company AirLiquide Argentina to perform this study.

Author information

Authors and Affiliations

  1. Sleep Laboratory, Pneumonology Unit, Hospital Alemán, Buenos Aires, Argentina

    Carlos Alberto Nigro, Eduardo Dibur & Silvana Malnis

  2. Instituto Argentino de Investigación Neurológica, Buenos Aires, Argentina

    Sofia Grandval & Facundo Nogueira

  3. Pedro Goyena 620, 3 B, 1424, Buenos Aires, Argentina

    Carlos Alberto Nigro

  4. Pueyrredón 1640, 1418, Buenos Aires, Argentina

    Eduardo Dibur & Silvana Malnis

  5. Uruguay 840, 1015, Buenos Aires, Argentina

    Sofia Grandval & Facundo Nogueira

Authors
  1. Carlos Alberto Nigro
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  2. Eduardo Dibur
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  3. Silvana Malnis
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  4. Sofia Grandval
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  5. Facundo Nogueira
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Correspondence to Carlos Alberto Nigro.

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Nigro, C.A., Dibur, E., Malnis, S. et al. Validation of ApneaLink Ox™ for the diagnosis of obstructive sleep apnea. Sleep Breath 17, 259–266 (2013). https://doi.org/10.1007/s11325-012-0684-4

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  • DOI: https://doi.org/10.1007/s11325-012-0684-4

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