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Pulse Oximetry Monitor Feasible for Early Screening of Obstructive Sleep Apnea (OSA)

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Abstract

Purpose

We postulate that using a simple pulse oximetry monitor (POM) to detect the severity of OSA will help clinical staff confirm the need for early treatment. Hence, we compared the POM-derived oxygen desaturation index (ODI) (events/h) with the polysomnography (PSG)-derived apnea–hypopnea index (AHI) (events/h). Our study is intended to validate the SpO2 measurements and related ODI4% and ODI3% (events/h) calculations from POM associated with AHI and ODI from PSG based on 2007 and 2012 criteria.

Methods

All 73 participants (mean age: 51.04 ± 13.14 years old) underwent an overnight PSG test and wore wristwatch POMs (PULSOX 300i) to automatically collect POM oxygen saturation (SpO2) data. Pearson correlation and the Bland and Altman method were used to verify the correlation between POM and PSG.

Results

We found that the POM SpO2 and the PSG2007 and PSG2012 scores were significantly highly correlated (total record time [TRT] and lowest SpO2, R2 = 0.815 and 0.817; ODI4%, R2 = 0.912 and 0.863 and ODI3%, R2 = 0.930 and 0.914). AHI was significantly correlated with ODI4% and ODI3%, but ODI3% was nonsignificantly higher (ODI4%, r = 0.955–0.929; ODI3%, r = 0.965–0.956). Both the ODI3% and the ODI4% were highly diagnostically sensitive and specific. The ODI3% score with the AHI 15 events/h cutoff was nonsignificantly higher (area under the curve [AUC] = 0.99, AHI 15 events/h; AUC = 0.95, AHI 5 events/h).

Conclusion

We conclude that the ODI3% score is a feasible early screening alternative for patients with moderate-to-severe OSA.

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Abbreviations

OSA:

Obstructive sleep apnea

POM:

Pulse oximetry monitor

ODI:

Oxygen desaturation index

ODI4% :

Oxygen desaturation index drops by 4% (events/h)

ODI3% :

Oxygen desaturation index drops by 3% (events/h)

AHI:

Apnea hypopnea index

PSG:

Polysomnography

PSG2007 :

Scoring criteria of the polysomnography in 2007

PSG2012 :

Scoring criteria of the polysomnography in 2012

SpO2 :

Oxygen saturation (%)

AUC:

The area under receiver operating characteristics (ROC) curve

ROC:

Under the receiver operating characteristic

AASM:

American academy of sleep medicine

RERAs:

Respiratory event-related arousals

PPG:

Photoplethysmography

BMI:

The body weight (in kilograms)/height2 (in meters)

NC:

The neck circumference (in cm)

PSQI:

Pittsburgh sleep quality index

ESS:

Epworth sleepiness scale

BDI:

Beck depression inventory II

TRT:

Total recording time

DS-5:

Development studio 5

EOG:

Electrooculography

ECG:

Electrocardiography

EMG:

Electromyography

EEG:

Electroencephalography

TST:

Total sleep time

Sens:

Sensitivity

Spec:

Specificity

NPV:

Negative predictive value

PPV:

Positive predictive value

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Acknowledgements

The authors thank the staff at the respiratory therapy technologists, Shuang Ho Hospital, Taipei Medical University for assistance. We are grateful to all volunteers for their participation in this study. We also specifically thank the medical staff who participated in the initial study focus on procedure controls and strategy.

Author information

Author notes

  1. Ling-Ling Chiang and Ching-Hsia Hung have contributed equally to this work.

Authors and Affiliations

  1. Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC

    Huei-Chen Lin & Ching-Hsia Hung

  2. Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, No.452, Huanqiu Rd. Luzhu Dist., Kaohsiung City, 82144, Taiwan, ROC

    Huei-Chen Lin

  3. School of Respiratory Therapy, Taipei Medical University, No. 250 Wuxing St, Taipei, 11031, Taiwan, ROC

    Chien-Ling Su & Ling-Ling Chiang

  4. Department of Thoracic Internal Medicine, Taipei Medical University-Shuang Ho Hospital, No.291, Zhongzheng Rd., Zhonghe District, New Taipei City, 23561, Taiwan, ROC

    Chien-Ling Su & Ling-Ling Chiang

  5. Department of Physical Therapy, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan, 701, Taiwan, ROC

    Jun-Hui Ong, kun-ling Tsai & Ching-Hsia Hung

  6. Department of Physical Therapy, College of Health Care, China Medical University, No.91, Hsueh-Shih Road., Taichung, 40402, Taiwan, ROC

    Yu-Wen Chen

  7. Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng-Li Road, North District, Tainan, 704, Taiwan, ROC

    Cheng-Yu Lin

  8. Department of Environmental and Occupational Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng-Li Road, North District, Tainan, 704, Taiwan, ROC

    Cheng-Yu Lin

  9. Department of Otolaryngology, Tainan Hospital, Ministry of Health and Welfare, No. 125, Zhong-Shan Road, West Central District, Tainan, 700, Taiwan, ROC

    Cheng-Yu Lin

Authors
  1. Huei-Chen Lin
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  4. kun-ling Tsai
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  5. Yu-Wen Chen
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Corresponding authors

Correspondence to Ling-Ling Chiang or Ching-Hsia Hung.

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Lin, HC., Su, CL., Ong, JH. et al. Pulse Oximetry Monitor Feasible for Early Screening of Obstructive Sleep Apnea (OSA). J. Med. Biol. Eng. 40, 62–70 (2020). https://doi.org/10.1007/s40846-019-00479-6

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  • DOI: https://doi.org/10.1007/s40846-019-00479-6

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