Original Articles
Cost–Effectiveness and Degree of Satisfaction With Home Sleep Monitoring in Patients With Symptoms of Sleep Apnea
Bernabé Jurado Gámeza,
, Javier Redel Monteroa, Luis Muñoz Cabreraa, Mari Carmen Fernández Marína, Elisa Muñoz Gomárizb, Miguel Ángel Martín Péreza, Andrés Cosano Povedanoa
Corresponding author
bjg01co@hotmail.com
Correspondence: Dr. B. Jurado Gámez. Servicio de Neumología. Hospital Universitario Reina Sofía. Avda. Menéndez Pidal, s/n. 14004 Córdoba. España
Correspondence: Dr. B. Jurado Gámez. Servicio de Neumología. Hospital Universitario Reina Sofía. Avda. Menéndez Pidal, s/n. 14004 Córdoba. España
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Jurado Gámez. Servicio de Neumología. Hospital Universitario Reina Sofía. Avda. Menéndez Pidal, s/n. 14004 Córdoba. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-11-16" "fechaAceptado" => "2007-03-20" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154661" "palabras" => array:4 [ 0 => "Home sleep monitoring" 1 => "Polysomnography" 2 => "Sleep-disordered breathing" 3 => "Sleep apnea–hypopnea syndrome" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154662" "palabras" => array:4 [ 0 => "Poligrafía domiciliaria" 1 => "Polisomnografía" 2 => "Trastornos respiratorios del sueño" 3 => "Síndrome de apneas-hipopneas durante el sueño" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetive</span><p class="elsevierStyleSimplePara elsevierViewall">To assess the diagnostic validity, degree of patient satisfaction, and economic cost of home sleep monitoring compared to conventional polysomnography.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Consecutive patients with symptoms indicative of sleep apnea-hypopnea syndrome (SAHS) were included. We analyzed the diagnostic yield of home sleep monitoring using the apnea–hypopnea index (AHI), number of desaturations of at least 3%, and the percentage time with arterial oxygen saturation below 90%. The degree of patient satisfaction, measured on a visual analogue scale, and the cost of home monitoring were compared with conventional polysomnography.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The study included 52 patients (42 men and 10 women) with a mean (SD) age of 51.8 (9) years and a body mass index of 32 (5) kg/<span class="elsevierStyleSup">2</span>. Polysomnography and home monitoring revealed an AHI of 33.6 (20) and 31 (19), respectively (<span class="elsevierStyleItalic">r</span>=0.971; intraclass correlation coefficient = 0.963; <span class="elsevierStyleItalic">P</span><.001). The number of desaturations of at least 3% and the percentage time with arterial oxygen saturation below 90% showed significant correlation and concordance (<span class="elsevierStyleItalic">P</span><.05). For an AHI cutoff of 10 recorded with polysomnography, home monitoring had a sensitivity of 89% and a specificity of 80%, with an area under the receiver operator characteristic curve of 0.804. For severe SAHS (AHI≥30), the sensitivity and specificity of home monitoring was 100% (that is, the area under the receiver operating characteristic curve was 1). For home monitoring, the cost per diagnostic test was €101.34 less than that of polysomnography, and the patient satisfaction was significantly greater (<span class="elsevierStyleItalic">P</span><.0001).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Home sleep monitoring is a valid and cost-effective diagnostic test; patients with symptoms of SAHS are more satisfied with this technique than conventional polysomnography.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Comparar la validez diagnóstica, el grado de satisfacción del paciente y el coste económico de la poligrafía domiciliaria respecto a la polisomnografía convencional.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se seleccionó consecutivamente a pacientes con síntomas indicativos de síndrome de apneas hipopneas durante el sueño (SAHS). Analizamos la rentabilidad de la poligrafía domiciliaria mediante el índice apneashipopneas (IAH), el índice de desaturación igual o mayor del 3% y el porcentaje de tiempo con una saturación arterial de oxígeno menor del 90%. Se compararon el grado de satisfacción del paciente, evaluada con una escala visual, y el coste de la poligrafía respecto a la polisomnografía.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyó en el estudio a 52 pacientes (42 varones y 10 mujeres) con una edad media ± desviación estándar de 51,8 ± 9 años e índice de masa corporal de 32 ± 5 kg/<span class="elsevierStyleSup">2</span>. La polisomnografía y la poligrafía obtuvieron un IAH de 33,6 ± 20 y de 31 ± 19, respectivamente (r = 0,971; coeficiente de correlación intraclase = 0,963; p < 0,001). Los valores del índice de desaturación igual o mayor del 3% y el porcentaje de tiempo con una saturación arterial de oxígeno menor del 90% mostraron una correlación y concordancia significativas (p < 0,05). Para un IAH obtenido en la polisomnografía de 10, la poligrafía mostró una sensibilidad del 89% y una especificidad del 80%, con un área bajo la curva de eficacia diagnóstica de 0,804; en el SAHS grave (IAH ≥ 30) la sensibilidad y especificidad de la poligrafía fue del 100% (área bajo la curva de eficacia diagnóstica = 1). En la poligrafía, el coste por prueba diagnóstica fue 101,34 € menor que en la polisomnografía, y el grado de satisfacción del paciente, significativamente mayor (p < 0,0001).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La poligrafía domiciliaria es una técnica diagnóstica válida y coste-eficiente, que aporta mayor grado de satisfacción que la polisomnografía convencional al paciente con síntomas de SAHS.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">Research project partially funded by the Neumosur Foundation.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Time course of sleep-related breathing disorderes in first-ever stroke or 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 6 | 10 |
| 2024 October | 30 | 33 | 63 |
| 2024 September | 26 | 41 | 67 |
| 2024 August | 37 | 51 | 88 |
| 2024 July | 22 | 23 | 45 |
| 2024 June | 32 | 27 | 59 |
| 2024 May | 26 | 34 | 60 |
| 2024 April | 20 | 29 | 49 |
| 2024 March | 17 | 14 | 31 |
| 2024 February | 20 | 18 | 38 |
| 2023 March | 3 | 2 | 5 |
| 2023 February | 11 | 27 | 38 |
| 2023 January | 12 | 27 | 39 |
| 2022 December | 16 | 16 | 32 |
| 2022 November | 15 | 25 | 40 |
| 2022 October | 15 | 33 | 48 |
| 2022 September | 14 | 29 | 43 |
| 2022 August | 15 | 36 | 51 |
| 2022 July | 15 | 34 | 49 |
| 2022 June | 14 | 35 | 49 |
| 2022 May | 13 | 23 | 36 |
| 2022 April | 8 | 20 | 28 |
| 2022 March | 15 | 39 | 54 |
| 2022 February | 14 | 27 | 41 |
| 2022 January | 13 | 40 | 53 |
| 2021 December | 12 | 44 | 56 |
| 2021 November | 11 | 65 | 76 |
| 2021 October | 16 | 41 | 57 |
| 2021 September | 12 | 69 | 81 |
| 2021 August | 7 | 38 | 45 |
| 2021 July | 9 | 24 | 33 |
| 2021 June | 7 | 36 | 43 |
| 2021 May | 5 | 29 | 34 |
| 2021 April | 7 | 30 | 37 |
| 2021 March | 16 | 19 | 35 |
| 2021 February | 7 | 12 | 19 |
| 2021 January | 10 | 17 | 27 |
| 2020 December | 7 | 13 | 20 |
| 2020 November | 11 | 9 | 20 |
| 2020 October | 6 | 9 | 15 |
| 2020 September | 12 | 10 | 22 |
| 2020 August | 8 | 11 | 19 |
| 2020 July | 6 | 12 | 18 |
| 2020 June | 9 | 3 | 12 |
| 2020 May | 9 | 17 | 26 |
| 2020 April | 11 | 16 | 27 |
| 2020 March | 6 | 7 | 13 |
| 2020 February | 5 | 25 | 30 |
| 2020 January | 10 | 18 | 28 |
| 2019 December | 9 | 15 | 24 |
| 2019 November | 3 | 7 | 10 |
| 2019 October | 5 | 2 | 7 |
| 2019 September | 15 | 9 | 24 |
| 2019 August | 15 | 7 | 22 |
| 2019 July | 50 | 14 | 64 |
| 2019 June | 33 | 3 | 36 |
| 2019 May | 25 | 16 | 41 |
| 2019 April | 8 | 33 | 41 |
| 2019 March | 11 | 26 | 37 |
| 2019 February | 12 | 11 | 23 |
| 2019 January | 11 | 15 | 26 |
| 2018 December | 13 | 16 | 29 |
| 2018 November | 16 | 10 | 26 |
| 2018 October | 18 | 17 | 35 |
| 2018 September | 15 | 10 | 25 |
| 2018 May | 1 | 0 | 1 |
| 2018 April | 8 | 7 | 15 |
| 2018 March | 5 | 3 | 8 |
| 2018 February | 5 | 10 | 15 |
| 2018 January | 2 | 6 | 8 |
| 2017 December | 10 | 7 | 17 |
| 2017 November | 3 | 6 | 9 |
| 2017 October | 5 | 10 | 15 |
| 2017 September | 4 | 8 | 12 |
| 2017 August | 6 | 8 | 14 |
| 2017 July | 3 | 7 | 10 |
| 2017 June | 6 | 11 | 17 |
| 2017 May | 8 | 14 | 22 |
| 2017 April | 2 | 5 | 7 |
| 2017 March | 2 | 12 | 14 |
| 2017 February | 3 | 8 | 11 |
| 2017 January | 1 | 5 | 6 |
| 2016 December | 8 | 2 | 10 |
| 2016 November | 12 | 6 | 18 |
| 2016 October | 19 | 12 | 31 |
| 2016 September | 4 | 3 | 7 |
| 2016 August | 5 | 5 | 10 |
| 2016 July | 1 | 6 | 7 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 1 | 0 | 1 |
| 2015 October | 35 | 6 | 41 |
| 2015 September | 33 | 4 | 37 |
| 2015 August | 21 | 6 | 27 |
| 2015 July | 39 | 4 | 43 |
| 2015 June | 32 | 5 | 37 |
| 2015 May | 32 | 17 | 49 |
| 2015 April | 27 | 9 | 36 |
| 2015 March | 36 | 8 | 44 |
| 2015 February | 24 | 3 | 27 |
| 2015 January | 25 | 6 | 31 |
| 2014 December | 26 | 3 | 29 |
| 2014 November | 24 | 8 | 32 |
| 2014 October | 55 | 8 | 63 |
| 2014 September | 25 | 6 | 31 |
| 2014 August | 34 | 10 | 44 |
| 2014 July | 27 | 7 | 34 |
| 2014 June | 42 | 6 | 48 |
| 2014 May | 33 | 10 | 43 |
| 2014 April | 45 | 3 | 48 |
| 2014 March | 48 | 9 | 57 |
| 2014 February | 40 | 11 | 51 |
| 2014 January | 22 | 6 | 28 |
| 2013 December | 33 | 7 | 40 |
| 2013 November | 26 | 6 | 32 |
| 2013 October | 30 | 5 | 35 |
| 2013 September | 38 | 10 | 48 |
| 2013 August | 27 | 9 | 36 |
| 2013 July | 38 | 11 | 49 |
| 2013 June | 27 | 6 | 33 |
| 2013 May | 23 | 5 | 28 |
| 2013 April | 22 | 5 | 27 |
| 2013 March | 7 | 1 | 8 |
Show all
