Scientific Investigations
The Utility of a Portable Recording Device for Screening of Obstructive Sleep Apnea in Obese Adolescents
http://dx.doi.org/10.5664/jcsm.1912
Daniel J. Lesser, M.D.1,3; Gabriel G. Haddad, M.D.1,2,3; Ruth A. Bush, Ph.D.3; Mark S. Pian, M.D.1,3
1Departments of Pediatrics (Division of Pediatric Respiratory Medicine), University of California-San Diego School of Medicine, San Diego, CA; 2Neurosciences, University of California-San Diego School of Medicine, San Diego, CA; 3Rady Children' Hospital-San Diego, San Diego, CA
Study Objectives:
The ApneaLink Plus is a portable recording device that measures air flow, respiratory effort, heart rate, and pulse oximetry. In the current study, we asked whether this device could be used to screen for obstructive sleep apnea in the pediatric population.
Methods:
Sleep-laboratory polysomnography (PSG) was performed simultaneously with measurements using the portable device on obese pediatric patients referred for snoring. The obstructive apnea hypopnea index (OAHI) was calculated automatically by the device (autoscore) and manually by the investigators. Sensitivity, specificity, correlation, and receiver operating curves (ROC) were used to compare the portable device to PSG.
Results:
Twenty-five subjects (60% male, mean age 13.6 ± 3.0 years, OAHI on PSG 11.8 ± 27.1) were studied. We identified a significant correlation between the OAHI of the ApneaLink autoscore and PSG (Spearman Rho = 0.886 [p < 0.001]). Using the PSG results as standard, ROC curves comparing the ApneaLink OAHI with the PSG OAHI demonstrated high congruence. The autoscore agreement was very good at PSG OAHI > 1.5 (area under the receiver operating curve [AUC] 0.965, OAHI > 5 [AUC 0.937], and OAHI > 10 [AUC 1.00]). The agreement of the manual score and autoscore were essentially equivalent. The device's autoscore demonstrated high sensitivity at all cutoffs examined (100% at OAHI > 1.5, 85.7% at OAHI > 5, and 100% at OAHI > 10). The specificity increased with increasing cutoffs (46.2% at OAHI > 1.5, 83.3% at OAHI > 5, and 90.0% at OAHI > 10).
Conclusion:
he ApneaLink Plus is a sensitive screening tool for evaluation of suspected OSAS in obese pediatric patients aged 9-18 years. The specificity improves with increasing OAHI cutoffs. The device detects OSAS when tested in a sleep laboratory on obese adolescents referred for symptoms of sleep related breathing disorder.
Citation:
Lesser DJ; Haddad GG; Bush RA; Pian MS. The utility of a portable recording device for screening of obstructive sleep apnea in obese adolescents. J Clin Sleep Med 2012;8(3):271-277.
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