Diagnostic Accuracy of Home-Based Monitoring System in Morbidly Obese Patients with High Risk for Sleep Apnea

Diagnostic Accuracy of Home-Based Monitoring System in Morbidly Obese Patients with High Risk for Sleep Apnea

Author Oliveira, Marcia G. Autor UNIFESP Google Scholar
Treptow, Erika C. Autor UNIFESP Google Scholar
Fukuda, Cesar Autor UNIFESP Google Scholar
Nery, Luiz E. Autor UNIFESP Google Scholar
Valadares, Rosana M. Autor UNIFESP Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Bittencourt, Lia Autor UNIFESP Google Scholar
Togeiro, Sonia M. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract No previous studies have validated the use of portable monitoring (PM) for the diagnosis of obstructive sleep apnea (OSA) in morbidly obese individuals. Our aim was to investigate the accuracy of PM for detecting respiratory events in morbidly obese patients that will be undergoing bariatric surgery.This was a prospective study involving patients with body mass index (BMI) a parts per thousand yen35 kg/m(2) who were recruited from the Sleep Clinic of Universidade Federal de So Paulo. Sleep-disordered breathing (SDB) was evaluated during full-night polysomnography (PSG). PM use was randomized and used on two consecutive nights: (1) at home (STDHome) and (2) at the sleep laboratory with PSG (PSG_STDLab).Although 58 participants initially underwent the recordings, 26 (45 %) were excluded because of technical problems. the patients' mean age was 42.9 +/- 10.9 (SD) years, and 56 % were female. the mean BMI was 40.8 +/- 5.2 kg/m(2). All patients had high risk for OSA, as defined by the Stop-Bang questionnaire, and the mean apnea-hypopnea index (AHI) was 46.9 +/- 30.4/h. the intraclass coefficient of the correlation between AHI_PSG and AHI_STDLab was r = 0.92 (p = 0.0001); the intraclass coefficient for AHI_PSG and AHI_STDHome was r = 0.84 (p = 0.0001). the Kappa index was 0.87 (p > 0.0001) for severe cases. the sensitivity and the positive predictive value increased with the disease severity. A Bland-Altman analysis showed good agreement between the investigated methods.PM is an efficacious method for diagnosing OSA in obese patients who have a high clinical probability of the disease. the method displays good sensitivity and specificity in severe cases; nevertheless, the high rate of data loss must be taken into account.
Keywords Obesity
Portable monitoring
Cardiorespiratory system
Type 3 monitoring
Polysomnography
Language English
Date 2015-05-01
Published in Obesity Surgery. New York: Springer, v. 25, n. 5, p. 845-851, 2015.
ISSN 0960-8923 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 845-851
Origin http://dx.doi.org/10.1007/s11695-014-1469-6
Access rights Closed access
Type Article
Web of Science ID WOS:000352906000015
URI http://repositorio.unifesp.br/handle/11600/39033

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