scholarly journals Accuracy and usability of AcuPebble SA100 for automated diagnosis of obstructive sleep apnoea in the home environment setting: an evaluation study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e046803
Author(s):  
Nikesh Devani ◽  
Renard Xaviero Adhi Pramono ◽  
Syed Anas Imtiaz ◽  
Stuart Bowyer ◽  
Esther Rodriguez-Villegas ◽  
...  
Keyword(s):  
Home Environment ◽  
Obstructive Sleep Apnoea ◽  
Predictive Value ◽  
Sleep Apnoea ◽  
Oxygen Desaturation ◽  
Diagnostic Methods ◽  
Automated Diagnosis ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Obstructive Sleep

ObjectivesObstructive sleep apnoea (OSA) is a heavily underdiagnosed condition, which can lead to significant multimorbidity. Underdiagnosis is often secondary to limitations in existing diagnostic methods. We conducted a diagnostic accuracy and usability study, to evaluate the efficacy of a novel, low-cost, small, wearable medical device, AcuPebble_SA100, for automated diagnosis of OSA in the home environment.SettingsPatients were recruited to a standard OSA diagnostic pathway in an UK hospital. They were trained on the use of type-III-cardiorespiratory polygraphy, which they took to use at home. They were also given AcuPebble_SA100; but they were not trained on how to use it.Participants182 consecutive patients had been referred for OSA diagnosis in which 150 successfully completed the study.Primary outcome measuresEfficacy of AcuPebble_SA100 for automated diagnosis of moderate–severe-OSA against cardiorespiratory polygraphy (sensitivity/specificity/likelihood ratios/predictive values) and validation of usability by patients themselves in their home environment.ResultsAfter returning the systems, two expert clinicians, blinded to AcuPebble_SA100’s output, manually scored the cardiorespiratory polygraphy signals to reach a diagnosis. AcuPebble_SA100 generated automated diagnosis corresponding to four, typically followed, diagnostic criteria: Apnoea Hypopnoea Index (AHI) using 3% as criteria for oxygen desaturation; Oxygen Desaturation Index (ODI) for 3% and 4% desaturation criteria and AHI using 4% as desaturation criteria. In all cases, AcuPebble_SA100 matched the experts’ diagnosis with positive and negative likelihood ratios over 10 and below 0.1, respectively. Comparing against the current American Academy of Sleep Medicine’s AHI-based criteria demonstrated 95.33% accuracy (95% CI (90·62% to 98·10%)), 96.84% specificity (95% CI (91·05% to 99·34%)), 92.73% sensitivity (95% CI (82·41% to 97·98%)), 94.4% positive-predictive value (95% CI (84·78% to 98·11%)) and 95.83% negative-predictive value (95% CI (89·94% to 98·34%)). All patients used AcuPebble_SA100 correctly. Over 97% reported a strong preference for AcuPebble_SA100 over cardiorespiratory polygraphy.ConclusionsThese results validate the efficacy of AcuPebble_SA100 as an automated diagnosis alternative to cardiorespiratory polygraphy; also demonstrating that AcuPebble_SA100 can be used by patients without requiring human training/assistance. This opens the doors for more efficient patient pathways for OSA diagnosis.Trial registration numberNCT03544086; ClinicalTrials.gov.

Relationship Between Obstructive Sleep Apnoea, Oxygen Desaturation and Cardiovascular Risk

2019 ◽  
Vol 70 (10) ◽  
pp. 3582-3586
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Obstructive Sleep Apnoea ◽  
Cardiovascular Events ◽  
Sleep Apnoea ◽  
Oxygen Desaturation ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Obstructive Sleep

Obstructive sleep apnoea syndrome (OSAS) increases the risk cardiovascular events regardless of the presence of previous cardiovascular disease. As both OSAS and coronary heart disease (CHD) have same risk factors it’s often difficult to quantify the proportion of each risk factor in developing cardiac events. The aim of this study was to evaluate the 10-year risk of developing a coronary heart disease (CHD) event or stroke in newly diagnosed OSAS patients. 65 patients diagnosed with OSAS over a period of four months in Oradea Sleep Laboratory were included. Demographic characteristics, anthropometric parameters, clinical and biochemical data, sleep disorder and daytime sleepiness assessment, results of polysomnography were collected in all patients. In 55 selected patients by age range from 34 to 74 years old, cardiovascular risk was assessed using Framingham score calculator. Statistical analysis was performed using SPSS-PC version 7.5 and Stata 10.The estimated 10-years risk of a CHD event was 18.97% (± 9.67) in all cases. It was higher in men (22.17% ± 9.24) compare to women (12.39% ± 6.92) and it was not significantly different by stages of OSAS severity (20.58% ±9.41 in patients with severe OSAS versus 15.4% in mild OSAS), suggesting that apnea hypopnea index is not a major confounding factor. Desaturation of oxygen is a better outcome to define the relation between OSAS and cardiovascular diseases. OSAS and cardiovascular risk factors increased risk for future adverse cardiovascular events related to the severity of oxygen desaturation. Keywords: obstructive sleep apnoea syndrome, cardiovascular events, risk factors, oxygen desaturation

scholarly journals Paediatric Sleep Questionnaire for Obstructive Sleep Apnoea Syndrome Screening: Is Sleep Quality Worthy of Note?

2021 ◽  
Vol 11 (4) ◽  
pp. 1440 ◽  
Author(s):  
Vera Panzarella ◽  
Giovanna Giuliana ◽  
Paola Spinuzza ◽  
Gaetano La Mantia ◽  
Laura Maniscalco ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Screening Tools ◽  
Obstructive Sleep Apnoea Syndrome ◽  
P Value ◽  
Predictive Values ◽  
Sleep Questionnaire ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep

Obstructive sleep apnoea syndrome (OSAS) is the most severe condition on the spectrum of sleep-related breathing disorders (SRBDs). The Paediatric Sleep Questionnaire (PSQ) is one of the most used and validated screening tools, but it lacks the comprehensive assessment of some determinants of OSAS, specifically anamnestic assessment and sleep quality. This study aims to assess the accuracy of some specific items added to the original PSQ, particularly related to the patient’s anamnestic history and to the quality of sleep, for the screening of OSAS in a paediatric population living in Sicily (Italy). Fifteen specific items, divided into “anamnestic” and “related to sleep quality” were added to the original PSQ. The whole questionnaire was administered via a digital form to the parents of children at 4 schools (age range: 3–13 years). For each item, sensitivity and specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. The highest sensitivity (80.0, 95% CI: 28.4; 99.5), in combination with the highest specificity (61.1, 95% CI: 35.7; 82.7), was found for the Item 32 (“assumption of bizarre or abnormal positions during sleep”). This item was found statistically significant for predicting the occurrence of OSAS in children (p-value ≤0.003). The study demonstrates the accuracy of specific items related to sleep quality disturbance for the preliminary assessment of the disease. Although these results should be validated on a larger sample of subjects, they suggest that including the factors discriminating sleep quality could further increase the efficiency and accuracy of PSQ.

scholarly journals Structural brain correlates of obstructive sleep apnoea in older adults at risk for dementia

2018 ◽  
Vol 52 (1) ◽  
pp. 1800740 ◽  
Author(s):  
Nathan E. Cross ◽  
Negar Memarian ◽  
Shantel L. Duffy ◽  
Casey Paquola ◽  
Haley LaMonica ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Sleep Disturbance ◽  
Obstructive Sleep Apnoea ◽  
Cortical Thickness ◽  
Neuropsychological Testing ◽  
Sleep Apnoea ◽  
Oxygen Desaturation ◽  
Obstructive Sleep ◽  
Brain Correlates

This study aimed to investigate associations between obstructive sleep apnoea (OSA) and cortical thickness in older adults with subjective and objective cognitive difficulties, who are considered “at-risk” for dementia.83 middle-aged to older adults (51–88 years) underwent neuropsychological testing, polysomnography assessment of OSA and a structural magnetic resonance imaging brain scan. A principal components analysis was performed on OSA measures. Cortical thickness and subcortical volumes were compared to extracted components of “oxygen desaturation” and “sleep disturbance”.Oxygen desaturation was significantly related to reduced cortical thickness in the bilateral temporal lobes (left: r=−0.44, p<0.001; right: r=−0.39, p=0.003). Conversely, sleep disturbance was associated with increased thickness in the right postcentral gyrus (r=0.48, p<0.001), pericalcarine (r=0.50, p=0.005) and pars opercularis (r=0.46, p=0.009) and increased volume of the hippocampus and amygdala. Decreased thickness in the bilateral temporal regions was associated with reduced verbal encoding (r=0.28, p=0.010).Given the clinical significance of this sample in terms of dementia prevention, these changes in grey matter reveal how OSA might contribute to neurodegenerative processes in older adults.

Smartphone videos to predict the severity of obstructive sleep apnoea

2021 ◽  
pp. archdischild-2020-320752
Author(s):  
Rahul J Thomas ◽  
Samuel Dalton ◽  
Katharine Harman ◽  
Julie Thacker ◽  
Rosemary S C Horne ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Obstructive Sleep Apnoea ◽  
Predictive Value ◽  
Work Of Breathing ◽  
Sleep Apnoea ◽  
Clinical Tool ◽  
Neck Extension ◽  
Obstructive Sleep ◽  
Sensitivity Specificity

ObjectiveDiagnosis of obstructive sleep apnoea (OSA) is made on overnight polysomnography (PSG). Given the widespread availability of smartphone video technology, we aimed to develop and test a standardised scoring system for smartphone videos and compare these scores to PSG results.MethodsChildren aged 1–16 years undergoing PSG for suspected OSA were included. Parents were asked to take 1–2 min videos of the breathing they were concerned about. Videos were scored using a newly developed and tested tool on five components: inspiratory obstructive noises (1–4), presence of obstructive events (0–1), increased work of breathing (0–1), mouth breathing (0–1) and neck extension (0–1). Video scores and the Obstructive Apnoea Hypopnoea Index (OAHI) were compared using Spearman correlation. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for different cut-off scores to achieve the best results.ResultsVideos from 43 children (28 men (65.1%), median age 5.7 years (range 2.6–14.0 years), median OAHI 3.8/hour (range 0–82 events/hour) were included. Nine children (20.9%) had a video score of <3, all of whom had an OAHI of ≤5 events/hour. For a video score of ≥3, sensitivity was 100%; specificity was 36%; positive predictive value was 53%; and negative predictive value 100% for moderate to severe OSA (OAHI>5 events/hour) .ConclusionWe have developed and validated a simple clinical tool (the Monash Obstructive Sleep Apnoea Video Score) to quantify abnormalities in breathing seen on short video recordings made on a smartphone. A low score rules out moderate–severe OSA and may be valuable in the triage of children with symptoms of OSA.

scholarly journals Predictive value of obstructive sleep apnoea assessed by the Berlin Questionnaire for outcomes after the catheter ablation of atrial fibrillation

EP Europace ◽  
2009 ◽  
Vol 11 (7) ◽  
pp. 896-901 ◽  
Author(s):  
Karuna Chilukuri ◽  
Darshan Dalal ◽  
Joseph E. Marine ◽  
Daniel Scherr ◽  
Charles A. Henrikson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Obstructive Sleep Apnoea ◽  
Predictive Value ◽  
Sleep Apnoea ◽  
Berlin Questionnaire ◽  
Obstructive Sleep

Association of epicardial fat thickness with clinical and polysomnographic parameters in non-obese obstructive sleep apnoea patients

2018 ◽  
Vol 132 (5) ◽  
pp. 439-445 ◽  
Author(s):  
S Derin ◽  
I Altun ◽  
S Koseoglu ◽  
C Sahin ◽  
M Yilmaz ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Oxygen Desaturation ◽  
Epicardial Fat ◽  
Epicardial Fat Thickness ◽  
Oxygen Desaturation Index ◽  
Obstructive Sleep ◽  
Fat Thickness

AbstractObjectives:This study aimed to investigate the relationship of epicardial fat thickness with severity of obstructive sleep apnoea, and clinical and polysomnographic parameters, and to determine independent predictors for epicardial fat thickness.Methods:A total of 84 patients with a body mass index of less than 30 kg/m2 and suspected sleep-disordered breathing were included in the study. The correlations of epicardial fat thickness with polysomnographic and clinical data, and severity of obstructive sleep apnoea, were investigated.Results:Mean epicardial fat thickness was 3.75 ± 1.07 mm in the study group (n = 62) and 2.97 ± 0.62 mm in the control group (n = 22) (p < 0.001). There were significant positive correlations between epicardial fat thickness and: apnoea/hypopnoea index, oxygen desaturation index 3 and minimum oxygen saturation, as well as with age, body mass index, and neck and waist circumferences.Conclusion:Non-obese obstructive sleep apnoea patients have thicker epicardial fat compared to controls. Oxygen desaturation index 3 has a strong correlation with epicardial fat thickness and is an independent predictor of it.

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