Abstract
Methods Prospective study conducted in a university hospital. Subjects with a clinical suspicion of SAHS were included. All of them underwent home polygraphy and oximetry on the same night. A correlation was made between the apnea-hypopnea index (AHI) and the oximetry variables. The variable with the highest diagnostic value was calculated using the area under the curve (AUC), and the best cut-off point for discriminating between patients with SAHS and severe SAHS was identified. Results One hundred and four subjects were included; 73 were men (70%); mean age was 52 ± 10.1 years; body mass index was 30 ± 4.1, and AHI = 29 ± 23.2/h. A correlation was observed between the AHI and oximetry variables, particularly ODI3 (r = 0.850; P < 0.001) and ODI4 (r = 0.912; P < 0.001). For an AHI ≥ 10/h, the ODI3 had an AUC = 0.941 (95% confidence interval (CI) = 0.899–0.982) and the ODI4, an AUC = 0.984 (95% CI = 0.964–1), with the ODI4 having the best cut-off point (5.4/h). Similarly, for an AHI ≥ 30/h, the ODI4 had an AUC = 0.922 (95% CI = 0.859–0.986), with the best cut-off point being 10.5/h. Conclusion Nocturnal oximetry is useful for diagnosing and evaluating the severity of SAHS. The ODI4 variable was most closely correlated with AHI for both diagnosis.
Highlights
Sleep apnea-hypopnea syndrome (SAHS) is a major public health problem due to its high prevalence, which can reach up to 25% among middle-aged adults [1]
A total of 119 subjects were included, 15 of whom were excluded (13%), 5 due to inconclusive polygraphy (4%) and 10 due to inconclusive oximetry (8%). e final sample was composed of 104 subjects: 74 (71%) were classified as sleep apnea hypopnea syndrome (SAHS), while 39 (37%) presented with severe SAHS (AHI ≥ 30/h)
E Pearson statistic was applied in order to determine the correlation between the apnea-hypopnea index (AHI) values and the pulse oximetry variables. e results are shown in Figure 1 and, as can be seen, the nocturnal SpO2 variables showed a significant correlation with AHI
Summary
Sleep apnea-hypopnea syndrome (SAHS) is a major public health problem due to its high prevalence, which can reach up to 25% among middle-aged adults [1]. It could be a tool available to primary care medicine Results obtained with this technique, are highly variable [13], and it is not recommended as a general practice in clinical practice guidelines [15]. Some authors have suggested that nocturnal oximetry could be a diagnostic alternative in subjects with symptoms of SAHS and could aid in therapeutic decision-making [10, 11]. These aspects have not been well studied in clinical practice conditions. To determine the diagnostic yield of nocturnal oximetry versus polygraphy for the diagnosis and classification of sleep apnea hypopnea syndrome (SAHS). Nocturnal oximetry is useful for diagnosing and evaluating the severity of SAHS. e ODI4 variable was most closely correlated with AHI for both diagnosis
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