Journal Article

Accuracy of a novel auto-CPAP device to evaluate the residual apnea-hypopnea index in patients with obstructive sleep apnea

Arce, Anabella, Aragone, María Rosario, González, Sergio, Nigro, Carlos Alberto, Nigro, Luciana

2015

Overview

Background Patients under treatment with continuous positive airway pressure (CPAP) may have residual sleep apnea (RSA). Objective The main objective of our study was to evaluate a novel auto-CPAP for the diagnosis of RSA. Methods All patients referred to the sleep laboratory to undergo CPAP polysomnography were evaluated. Patients treated with oxygen or noninvasive ventilation and split-night polysomnography (PSG), PSG with artifacts, or total sleep time less than 180 min were excluded. The PSG was manually analyzed before generating the automatic report from auto-CPAP. PSG variables (respiratory disturbance index (RDI), obstructive apnea index, hypopnea index, and central apnea index) were compared with their counterparts from auto-CPAP through Bland–Altman plots and intraclass correlation coefficient. The diagnostic accuracy of autoscoring from auto-CPAP using different cutoff points of RDI (≥5 and 10) was evaluated by the receiver operating characteristics (ROCs) curve. Results The study included 114 patients (24 women; mean age and BMI, 59 years old and 33 kg/m 2 ; RDI and apnea/hypopnea index (AHI)-auto median, 5 and 2, respectively). The average difference between the AHI-auto and the RDI was −3.5 ± 3.9. The intraclass correlation coefficient (ICC) between the total number of central apneas, obstructive, and hypopneas between the PSG and the auto-CPAP were 0.69, 0.16, and 0.15, respectively. An AHI-auto >2 (RDI ≥ 5) or >4 (RDI ≥ 10) had an area under the ROC curve, sensitivity, specificity, positive likelihood ratio, and negative for diagnosis of residual sleep apnea of 0.84/0.89, 84/81 %, 82/91 %, 4.5/9.5, and 0.22/0.2, respectively. Conclusions The automatic analysis from auto-CPAP (S9 Autoset) showed a good diagnostic accuracy to identify residual sleep apnea. The absolute agreement between PSG and auto-CPAP to classify the respiratory events correctly varied from very low (obstructive apneas, hypopneas) to moderate (central apneas).

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Accuracy / Body weight / Continuous positive airway pressure / Continuous Positive Airway Pressure - instrumentation / Dentistry / Female / Humans / Indexes / Internal Medicine / Male / Medical diagnosis / Medical equipment / Medical treatment / Medicine / Medicine & Public Health / Middle Aged / Nasal continuous positive airway pressure / Neurology / Obstructive sleep apnea / Original Article / Otorhinolaryngology / Oxygen / Patients / Pediatrics / Pneumology/Respiratory System / Polysomnography / Polysomnography - instrumentation / Prospective Studies / Signal Processing, Computer-Assisted - instrumentation / Sleep / Sleep apnea / Sleep Apnea, Obstructive - diagnosis / Sleep Apnea, Obstructive - therapy / Therapy, Computer-Assisted - instrumentation / Treatment Outcome / Ventilation / Women