Oximetry in Diagnosis of Sleep Apnea Hypopnea Syndrome_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 YangLin ¹ , HeQuanying ² , WangNiangdi ¹ , ZhengQiwen ¹ , YuLanfang ¹ , WangFengqing ¹

1. Department of Health Medicine, Shenzhen Hospital, Peking University, Shenzhen, Guangdong, 518036, China;
2. ;

Corresponding author：

YangLin, Email: 13510331309@139.com

Keywords：

Sleep apnea hypopnea syndrome; Oximetry; Oxygen desaturation index; Apnea hyponea index

DOI：

10.7507/1671-6205.2016115

Video：

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Objective To investigate the diagnostic value of oximetry in sleep apnea hypopnea syndrome (SAHS). Methods Adult patients suspected for SAHS were enrolled between May 2010 and May 2013. The patients underwent both polysomnography (PSG) and oximetry for further diagnosis. Apnea hyponea index (AHI) and oxygen desaturation index four (ODI4) were calculated on a single night. The relationship between AHI and ODI4 were analyzed. Results A total of 628 adult patients were recruited.ODI4 was linearly correlated with AHI with a regression coefficient of almost 1. The cut-off values of ODI4 for indentifing SAHS and moderate to severe SAHS were 10 events per hour and 20 events per hour, with specificities of 99.9% and 99.3%, and AUCs of 0.931 and 0.934, respectively. Female, lower weight and less severe SAHS patients were easily misdiagnosed. Conclusions There is a high agreement between AHI and ODI4. Oximetry is less likely misdiagnose SAHS.

Citation： Yang Lin, He Quanying, Wang Niangdi, Zheng Qiwen, Yu Lanfang, Wang Fengqing. Oximetry in Diagnosis of Sleep Apnea Hypopnea Syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(5): 500-505. doi: 10.7507/1671-6205.2016115 Copy

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2.	Mulgrew AT, Fox N, Ayas NT, et al. Diagnosis and initial management of obstructive sleep apnea without polysomnograghy:a randomized validation study. Ann Intern Med, 2007, 146:157-66.
3.	American Academy of Sleep Medicine. Portable monitoring in the diagnosis of obstructive sleep apnea. J Clin Sleep Med, 2006, 2:274.
4.	Collop NA, Anerson WM, Boehlecke B, et al. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med, 2007, 3:737-747.
5.	Berry RB, Budhiraja R, Gottlieb DJ, et al. American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep:update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med, 2012, 8:597-619.
6.	Vázquez JC, Tsai WH, Flemons WW, et al. Automated analysis of digital oximetry in the diagnosis of obstructive sleep apnoea. Thorax, 2000, 55:302-307.
7.	Jobin V, Mayer P, Bellemare F. Predictive value of automated oxygen saturation analysis for the diagnosis and treatment of obstructive sleep apnoea in a home-based setting. Thorax, 2007, 62:422-427.
8.	Ferber R, Millman R, Coppola M, et al. Portable recording in the assessment of obstructive sleep apnea. ASDA standards of practice. Sleep, 1994, 17:378-392.
9.	Cooper BG, Veale D, Griffiths CJ, et al. Value of nocturnal oxygen saturation as a screening test for sleep apnoea. Thorax, 1991, 46:586-588.
10.	Lin CL, Yeh C, Yen CW, et al. Comparison of the indices of oxyhemoglobin saturation by pulse oximetry in obstructive sleep apnea hypopnea syndrome. Chest, 2009, 135:86-93.
11.	韩芳, 陈尔璋, 魏海琳, 等.夜间血氧饱和度监测对睡眠呼吸暂停综合征的诊断价值.中华结核和呼吸杂志, 1999, 22:332-334.
12.	Strohl KP, Altose MD. Oxygen saturation during breath-holding and during apneas in sleep. Chest, 1984, 85:181-186.
13.	Series F, Cormier Y, La Forge J. Role of lung volumes in sleep apnoea-related oxygen desaturation. Eur Respir J, 1989, 2:26-30.
14.	Ayappa I, Rapaport BS, Norman RG, et al. Immediate consequences of respiratory events in sleep disordered breathing. Sleep Med, 2005, 6:123-130.
15.	Kuna ST. Portable-monitor testing:an alternative strategy for managing patients with obstructive sleep apnea. Respir Care, 2010, 55:1196-215.

1. 中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版).中华结核和呼吸杂志, 2012, 35:9-12.
2. Mulgrew AT, Fox N, Ayas NT, et al. Diagnosis and initial management of obstructive sleep apnea without polysomnograghy:a randomized validation study. Ann Intern Med, 2007, 146:157-66.
3. American Academy of Sleep Medicine. Portable monitoring in the diagnosis of obstructive sleep apnea. J Clin Sleep Med, 2006, 2:274.
4. Collop NA, Anerson WM, Boehlecke B, et al. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med, 2007, 3:737-747.
5. Berry RB, Budhiraja R, Gottlieb DJ, et al. American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep:update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med, 2012, 8:597-619.
6. Vázquez JC, Tsai WH, Flemons WW, et al. Automated analysis of digital oximetry in the diagnosis of obstructive sleep apnoea. Thorax, 2000, 55:302-307.
7. Jobin V, Mayer P, Bellemare F. Predictive value of automated oxygen saturation analysis for the diagnosis and treatment of obstructive sleep apnoea in a home-based setting. Thorax, 2007, 62:422-427.
8. Ferber R, Millman R, Coppola M, et al. Portable recording in the assessment of obstructive sleep apnea. ASDA standards of practice. Sleep, 1994, 17:378-392.
9. Cooper BG, Veale D, Griffiths CJ, et al. Value of nocturnal oxygen saturation as a screening test for sleep apnoea. Thorax, 1991, 46:586-588.
10. Lin CL, Yeh C, Yen CW, et al. Comparison of the indices of oxyhemoglobin saturation by pulse oximetry in obstructive sleep apnea hypopnea syndrome. Chest, 2009, 135:86-93.
11. 韩芳, 陈尔璋, 魏海琳, 等.夜间血氧饱和度监测对睡眠呼吸暂停综合征的诊断价值.中华结核和呼吸杂志, 1999, 22:332-334.
12. Strohl KP, Altose MD. Oxygen saturation during breath-holding and during apneas in sleep. Chest, 1984, 85:181-186.
13. Series F, Cormier Y, La Forge J. Role of lung volumes in sleep apnoea-related oxygen desaturation. Eur Respir J, 1989, 2:26-30.
14. Ayappa I, Rapaport BS, Norman RG, et al. Immediate consequences of respiratory events in sleep disordered breathing. Sleep Med, 2005, 6:123-130.
15. Kuna ST. Portable-monitor testing:an alternative strategy for managing patients with obstructive sleep apnea. Respir Care, 2010, 55:1196-215.

Chinese Journal of Respiratory and Critical Care Medicine

Oximetry in Diagnosis of Sleep Apnea Hypopnea Syndrome

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