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Effectiveness of nocturnal oximetry in predicting obstructive sleep apnea hypopnea syndrome: value of nocturnal oximetry in prediction of obstructive sleep apnea hypopnea syndrome

Abstract

Background

Polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea (OSA). However, it is time-consuming, expensive and requires technical expertise. Thus, a number of alternatives to PSG have been proposed. The present study was conducted to analyse the sensitivity, specificity and accuracy of night oximetry as a diagnostic tool in patients suspected to have sleep apnea hypopnea syndrome (SAHS), and to reduce the number of saved PSGs.

Patients and methods

In total, 40 middle-aged patients clinically suspected to haveObstructive Sleep Apnea Hypopnea Syndrome (OSAHS) were included in the study. They were classified into two groups: group I (the SAHS group), comprising 33patientswithapneahypopneaindex greater than or equal to5; and group II (the non-SAHS group), comprising seven patients with apnea hypopnea index l than 5. All patients were subjected to the following: (a) OSA screening questionnaire; (b) BMI in kg/m2, neck circumference in cm, and cardiac, chest and ENT examinations; (c) investigationintheform of arterialbloodgases, chest radiograph, ECG and spirometry; and (d) full PSG and overnight oximetry, which were carried out simultaneously.

Results

The baseline values of O2 saturation derived from PSG and oximetry were 93.33±2.32 and 91.50±2.79, respectively. The overnight oxygen desaturation index of oximetry was significantly lower in the SAHS group. Minimal SpO2 of PSG was significantly lower in the SAHS group. The best predicted cutoff value of overnight pulse oximetry using oxygen desaturation index for mild to moderate OSA patient diagnosis was 14.78, with 87.88% sensitivity and 88.71% specificity. However, the optimal cutoff value for severe OSA diagnosis was 52.55, with 86.67% sensitivity and 96% specificity.

Conclusion

Overnight pulse oximetry may be considered a diagnostic tool in patients suspected to have SAHS, with excellent diagnostic sensitivity, specificity and accuracy, which increased with severity.

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Correspondence to Lucy A. Suliman.

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This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

The study was presented at the 57th Annual Conference of Egyptian Society of Chest and Tuberculosis in Fairmont Heliopolis, Cairo, Egypt on 29 March 2016.

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Suliman, L.A., Shalabi, N.M., Elmorsy, S.A. et al. Effectiveness of nocturnal oximetry in predicting obstructive sleep apnea hypopnea syndrome: value of nocturnal oximetry in prediction of obstructive sleep apnea hypopnea syndrome. Egypt J Bronchol 10, 324–329 (2016). https://doi.org/10.4103/1687-8426.193647

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Keywords

  • apnea hypopnea index
  • night oximetry
  • obstructive sleep apnea
  • polysomnography
  • sleep apnea hypopnea syndrome