Journal Information
Vol. 43. Issue 12.
Pages 649-654 (January 2007)
Share
Share
Download PDF
More article options
Vol. 43. Issue 12.
Pages 649-654 (January 2007)
ORIGINAL ARTICLES
Full text access
Agreement Between Oxygen Desaturation Index and Apnea-Hypopnea Index in Adults With Suspected Obstructive Sleep Apnea at an Altitude of 2240 m
Visits
8672
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
This item has received
Article information
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
Full text is only aviable in PDF
REFERENCES
[1]
CA Kushida, MR Littner, T Morgenthaler, CA Alessi, D Bailey, J Coleman Jr, et al.
Practice parameters for the indications for polysomnography and related procedures: an update for 2005.
Sleep, 28 (2005), pp. 499-521
[2]
WW Flemons, NJ Douglas, ST Kuna, DO Rodenstein, J Wheatley.
Access to diagnosis and treatment of patients with suspected sleep apnea.
Am J Respir Crit Care Med, 169 (2004), pp. 668-672
[3]
CK Li, WW Flemons.
State of home sleep studies.
Clin Chest Med, 24 (2003), pp. 283-295
[4]
WA Whitelaw, RF Brant, WW Flemons.
Clinical usefulness of home oximetry compared with polysomnography for assessment of sleep apnea.
Am J Respir Crit Care Med, 171 (2005), pp. 188-193
[5]
JC Vazquez, WH Tsai, WW Flemons, A Masuda, R Brant, E Hajduk, et al.
Automated analysis of digital oximetry in the diagnosis of obstructive sleep apnoea.
Thorax, 55 (2000), pp. 302-307
[6]
Y Wang, T Teschler, G Weinreich, S Hess, TE Wessendorf, H Teschler.
Validation of microMESAM as screening device for sleep disordered breathing.
Pneumologie, 57 (2003), pp. 734-740
[7]
J Steier, Y Wang, TE Wessendorf, YM Wang, H Teschler.
Home screening in moderate sleep apnea: a comparison with polysomnography.
Proc Am Thorac Soc, 2 (2005), pp. A767
[8]
A Reschtaschaffen, A Kales.
A manual of standardized terminology scoring system for sleep stages of human subjects, Public Health Service, US Government Printing Office, (1968),
[9]
American Academy of Sleep Medicine Task Force.
Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force.
Sleep, 22 (1999), pp. 667-689
[10]
T Young, M Palta, J Dempsey, J Skatrud, S Weber, S Badr.
The occurrence of sleep disordered breathing among middle-aged adults.
N Engl J Med, 328 (1993), pp. 1230-1235
[11]
L Torre-Bouscoulet, E Chávez, MS Meza, JC Vázquez, F Franco, A Muino, et al.
Snoring and sleep-related symptoms in three Latin- American Cities.
Proc Am Thorac Soc, 2 (2005), pp. A767
[12]
C Pellicer-Císcar.
Cambios en el perfil de una consulta neumológica comarcal. Perspectiva de 10 años.
Arch Bronconeumol, 42 (2006), pp. 516-521
[13]
L Torre-Bouscoulet, E López-Escárcega, A Castorena-Maldonado, JC Vázquez-García, MS Meza-Vargas, R Pérez-Padilla.
Uso de CPAP en adultos con síndrome de apneas obstructivas durante el sueño después de prescripción en un hospital público de referencia de la Ciudad de México.
Arch Bronconeumol, 43 (2007), pp. 16-21
[14]
J Durán-Cantolla.
¿Hacia dónde va el diagnóstico del síndrome de apneas-hipopneas durante el sueño?.
Arch Bronconeumol, 41 (2005), pp. 645-648
[15]
HE Dincer, W O'Neill.
Deleterious effects of sleep-disordered breathing on the heart and vascular system.
Respiration, 73 (2006), pp. 124-130
[16]
K Tatsumi, Y Kasahara, K Kurosu, N Tanabe, Y Takiguchi, T Kuriyama.
Sleep oxygen desaturation and circulating leptin in obstructive sleep apnea-hypopnea syndrome.
Chest, 127 (2005), pp. 716-721
[17]
S Ryan, CT Taylor, WT McNicholas.
Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome.
Circulation, 112 (2005), pp. 2660-2667
[18]
L Lavie.
Sleep-disordered breathing and cerebrovascular disease: a mechanistic approach.
Neurol Clin, 23 (2005), pp. 1059-1075
Copyright © 2007. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?