Agreement Between Oxygen Desaturation Index and Apnea-Hypopnea Index in Adults With Suspected Obstructive Sleep Apnea at an Altitude of 2240 m

Torre-Bouscoulet, Luis; Castorena-Maldonado, Armando; Baños-Flores, Rocío; Carlos Vázquez-García, Juan; Sonia Meza-Vargas, María; Pérez-Padilla, Rogelio

doi:10.1016/S1579-2129(07)60150-5

Archivos de Bronconeumología

ISSN: 0300-2896

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Vol. 43. Issue 12.

Pages 649-654 (January 2007)

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Pages 649-654 (January 2007)

ORIGINAL ARTICLES

DOI: 10.1016/S1579-2129(07)60150-5

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Agreement Between Oxygen Desaturation Index and Apnea-Hypopnea Index in Adults With Suspected Obstructive Sleep Apnea at an Altitude of 2240 m

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Luis Torre-Bouscoulet

Corresponding author

luistorreb2001@yahoo.com.mx

Correspondence: Dr. L. Torre Bouscoulet. Clínica de Trastornos Respiratorios del Dormir. Instituto Nacional de Enfermedades Respiratorias. Tlalpan, 4.502. Colonia Sección XVI. Delegación Tlalpan. 14080 México, DF. México.

, Armando Castorena-Maldonado, Rocío Baños-Flores, Juan Carlos Vázquez-García, María Sonia Meza-Vargas, Rogelio Pérez-Padilla

Clínica de Sueño, Instituto Nacional de Enfermedades Respiratorias, México, DF, Mexico

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OBJECTIVE

Altitude can affect the diagnostic accuracy of portable monitors used to diagnose suspected obstructive sleep apnea syndrome on the basis of oxygen desaturation measurements. The aim of this study was to determine agreement between the desaturation index measured by oximetry and the apnea-hypopnea index measured by polysomnography in Mexico City (2240 m above sea level). We also wished to determine agreement between the desaturation index and the respiratory disturbance index measured by monitoring airflow with a single-channel recording device.

PATIENTS AND METHODS

We used standard polysomnography and nocturnal oximetry (Remmers Sleep Recorder, Sagatech, Calgary, Alberta, Canada) to simultaneously measure the apnea-hypopnea index and the desaturation index, respectively, in a group of 38 patients aged over 18 years with suspected obstructive sleep apnea syndrome. In a second group of 30 patients, we compared the desaturation index to the respiratory disturbance index, which we measured using a single-channel device monitoring nasal airflow (Apnea Link, ResMel Corp., Poway, CA, USA).

RESULTS

The mean (SD) intraclass correlation coefficient between the apnea-hypopnea index and the desaturation index was 0.89 (0.03) (95% confidence interval, 0.83-0.96), and the mean of the differences was -0.9 (14.2). The mean intraclass correlation coefficient for the desaturation index and the respiratory disturbance index was 0.93 (0.02) (95% confidence interval, 0.89-0.97), and the mean of the differences was -6.6 (8.3).

CONCLUSIONS

Agreement was high between the desaturation index and both the apnea-hypopnea index and the respiratory disturbance index in adults with suspected obstructive sleep apnea syndrome in Mexico City.

Key words:

Sleep apnea

Altitude

Portable monitor

Apnea-hypopnea index

OBJETIVO

La altitud puede afectar la rentabilidad diagnóstica de los monitores portátiles basados en la desaturación de oxígeno en pacientes con sospecha de síndrome de apneas obstructivas durante el sueño (SAOS). Nuestro propósito es comparar, en Ciudad de México (2.240 m de altitud), el índice de desaturaciones, obtenido con un oxímetro, con el índice polisomnográfico de apneas-hipopneas. Se comparó también el índice de desaturaciones con el índice respiratorio obtenido con un monitor monocanal de detección de flujo.

PACIENTES Y MÉTODOS

A 38 pacientes mayores de 18 años con sospecha de SAOS, se les realizaron simultáneamente una polisomnografía estándar y una oximetría nocturna (Rem-mers Sleep Recorder, Sagatech, Calgary, Alberta, Canadá) para identificar el índice de apneas-hipopneas y el índice de desaturaciones, respectivamente. En otro grupo de 30 pacien-tes se comparó el índice de desaturaciones con el índice respi-ratorio basado en flujo obtenido de un sistema monocanal de flujo nasal (ApneaLink, ResMed Corp., Poway, CA, EE. UU.).

RESULTADOS

El coeficiente de correlación intraclase entre el índice de apneas-hipopneas y el de desaturaciones fue de 0,89 ± 0,03 (intervalo de confianza del 95%, 0,83-0,96); la media de las diferencias fue de -0,9 ± 14,2. Al comparar el índice de desaturaciones y el índice respiratorio basado en el flujo nasal, el coeficiente de correlación intraclase fue de 0,93 ± 0,02 (intervalo de confianza del 95%, 0,89-0,97), y la media de las diferencias, de -6,6 ± 8,3.

CONCLUSIONES

En Ciudad de México, en adultos con sos-pecha de SAOS, se observó una alta concordancia entre el índice polisomnográfico de apneas-hipopneas y el índice de desaturaciones, así como entre éste y el índice respiratorio basado en el flujo nasal.

Palabras clave:

Apnea del sueño

Altitud

Monitor portátil

Índi-ce de apneas-hipopneas

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