Sleep apnea other diagnostic studies: Difference between revisions
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Oximetry may identify some patients whose outcomes are not improved by adding polysomnography.<ref name="pmid17283346">{{cite journal| author=Mulgrew AT, Fox N, Ayas NT, Ryan CF| title=Diagnosis and initial management of obstructive sleep apnea without polysomnography: a randomized validation study. | journal=Ann Intern Med | year= 2007 | volume= 146 | issue= 3 | pages= 157-66 | pmid=17283346 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17283346 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17909239 Review in: Evid Based Med. 2007 Oct;12(5):148] [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17764136 Review in: ACP J Club. 2007 Sep-Oct;147(2):45] </ref> | Oximetry, which may be performed overnight in a a patient's home, is an easier alternative to formal sleep study ([[polysomnography]]. | ||
* In one study, normal overnight oximetry was very [[Sensitivity and specificity|sensitive]] and so if normal, sleep apnea was unlikely.<ref name="pmid8357109">{{cite journal| author=Sériès F, Marc I, Cormier Y, La Forge J| title=Utility of nocturnal home oximetry for case finding in patients with suspected sleep apnea hypopnea syndrome. | journal=Ann Intern Med | year= 1993 | volume= 119 | issue= 6 | pages= 449-53 | pmid=8357109 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8357109 }} </ref> In addition, home oximetry may be equally effect in guiding prescription for automatically self-adjusting [[continuous positive airway pressure]].<ref name="pmid15486338">{{cite journal| author=Whitelaw WA, Brant RF, Flemons WW| title=Clinical usefulness of home oximetry compared with polysomnography for assessment of sleep apnea. | journal=Am J Respir Crit Care Med | year= 2005 | volume= 171 | issue= 2 | pages= 188-93 | pmid=15486338 | doi=10.1164/rccm.200310-1360OC | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15486338 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15989309 Review in: ACP J Club. 2005 Jul-Aug;143(1):21] </ref> | |||
*Another study found that overnight oximetry, defining abnormal as 15 or more 4% desaturations/hour, was very [[Sensitivity and specificity|specific]], but not [[Sensitivity and specificity|sensitive]].<ref name="pmid8539678">{{cite journal| author=Ryan PJ, Hilton MF, Boldy DA, Evans A, Bradbury S, Sapiano S et al.| title=Validation of British Thoracic Society guidelines for the diagnosis of the sleep apnoea/hypopnoea syndrome: can polysomnography be avoided? | journal=Thorax | year= 1995 | volume= 50 | issue= 9 | pages= 972-5 | pmid=8539678 | doi= | pmc=PMC1021311 | url= }} </ref> | |||
* Sensitivty of overnight oximetry is improved by using a 3% desaturation in oxygen.<ref name="pmid22009031">{{cite journal| author=Nigro CA, Dibur E, Rhodius E| title=Accuracy of the clinical parameters and oximetry to initiate CPAP in patients with suspected obstructive sleep apnea. | journal=Sleep Breath | year= 2012 | volume= 16 | issue= 4 | pages= 1073-9 | pmid=22009031 | doi=10.1007/s11325-011-0603-0 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22009031 }} </ref> and lowering the ODI to 5 per hour.<ref name="pmid1346422">{{cite journal| author=Douglas NJ, Thomas S, Jan MA| title=Clinical value of polysomnography. | journal=Lancet | year= 1992 | volume= 339 | issue= 8789 | pages= 347-50 | pmid=1346422 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1346422 }} </ref> | |||
* Oximetry may identify some patients whose outcomes are not improved by adding polysomnography.<ref name="pmid17283346">{{cite journal| author=Mulgrew AT, Fox N, Ayas NT, Ryan CF| title=Diagnosis and initial management of obstructive sleep apnea without polysomnography: a randomized validation study. | journal=Ann Intern Med | year= 2007 | volume= 146 | issue= 3 | pages= 157-66 | pmid=17283346 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17283346 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17909239 Review in: Evid Based Med. 2007 Oct;12(5):148] [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17764136 Review in: ACP J Club. 2007 Sep-Oct;147(2):45] </ref> | |||
==References== | ==References== | ||
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Oximetry, which may be performed overnight in a a patient's home, is an easier alternative to formal sleep study (polysomnography.
- In one study, normal overnight oximetry was very sensitive and so if normal, sleep apnea was unlikely.[1] In addition, home oximetry may be equally effect in guiding prescription for automatically self-adjusting continuous positive airway pressure.[2]
- Another study found that overnight oximetry, defining abnormal as 15 or more 4% desaturations/hour, was very specific, but not sensitive.[3]
- Sensitivty of overnight oximetry is improved by using a 3% desaturation in oxygen.[4] and lowering the ODI to 5 per hour.[5]
- Oximetry may identify some patients whose outcomes are not improved by adding polysomnography.[6]
References
- ↑ Sériès F, Marc I, Cormier Y, La Forge J (1993). "Utility of nocturnal home oximetry for case finding in patients with suspected sleep apnea hypopnea syndrome". Ann Intern Med. 119 (6): 449–53. PMID 8357109.
- ↑ Whitelaw WA, Brant RF, Flemons WW (2005). "Clinical usefulness of home oximetry compared with polysomnography for assessment of sleep apnea". Am J Respir Crit Care Med. 171 (2): 188–93. doi:10.1164/rccm.200310-1360OC. PMID 15486338. Review in: ACP J Club. 2005 Jul-Aug;143(1):21
- ↑ Ryan PJ, Hilton MF, Boldy DA, Evans A, Bradbury S, Sapiano S; et al. (1995). "Validation of British Thoracic Society guidelines for the diagnosis of the sleep apnoea/hypopnoea syndrome: can polysomnography be avoided?". Thorax. 50 (9): 972–5. PMC 1021311. PMID 8539678.
- ↑ Nigro CA, Dibur E, Rhodius E (2012). "Accuracy of the clinical parameters and oximetry to initiate CPAP in patients with suspected obstructive sleep apnea". Sleep Breath. 16 (4): 1073–9. doi:10.1007/s11325-011-0603-0. PMID 22009031.
- ↑ Douglas NJ, Thomas S, Jan MA (1992). "Clinical value of polysomnography". Lancet. 339 (8789): 347–50. PMID 1346422.
- ↑ Mulgrew AT, Fox N, Ayas NT, Ryan CF (2007). "Diagnosis and initial management of obstructive sleep apnea without polysomnography: a randomized validation study". Ann Intern Med. 146 (3): 157–66. PMID 17283346. Review in: Evid Based Med. 2007 Oct;12(5):148 Review in: ACP J Club. 2007 Sep-Oct;147(2):45