Significance of a screening device (Apnomonitor 5®) for sleep apnea syndrome
Introduction
Sleep apnea syndrome (SAS), regardless of the ethnicity, is very common disease in the 21st century. The prevalence of SAS, defined by an apnea–hypopnea index (AHI) of ≥5 s, is generally higher in men than women: 24% in men and 9% in women in the USA [1], and 27% in men and 16% in women in Korea [2]. SAS is often complicated by hypertension, coronary heart disease and cerebrovascular accident, and it may accelerate the progression of these diseases and affect their prognoses adversely [3], [4]. Excessive daytime sleepiness (EDS) of a characteristic symptom of SAS disturbs not only the individual life but also the social activities especially in patients involved in public transportation, employees and students.
It is needless to say that polysomnography (PSG) is essential to diagnose SAS. However, PSG requires a facility, expense, complicated monitoring and overnight observation by examiners. Hence, several portable and unattended sleep-monitoring devices have been developed for screening for SAS [5], [6], [7].
In this context, the purpose of this study was to assess the clinical utility of the Apnomonitor 5® (Chest Co., Tokyo, Japan), a commercially available screening device, for screening for SAS. Then we compared it with standard PSG to determine its sensitivity and specificity for diagnosing SAS.
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Subjects
The standard PSG and Apnomonitor 5® were performed simultaneously in 22 consecutive adult suspects of SAS who were referred to the Inazawa City Hospital during the 18-month-period from March 2005. Patients were 17 men and 5 women with ages of 52.9 ± 13.3 years (mean ± S.D., range, 31–74 years) and body mass index (BMI) of 25.7 ± 4.4 kg/m2 (18.8–39.3 kg/m2). The protocol was approved by the ethical committee of the Inazawa City Hospital and a written informed consent was obtained from each patient.
Polysomnography
The
Results
Objective measures of sleep assessed by the PSG and Apnomonitor 5® are shown in Table 2. The AI and HI were significantly different between the two methods. The AI was greater with the PSG than Apnomonitor: 26.4 ± 23.0 (events per hour) for the PSG and 23.7 ± 22.1 for the Apnomonitor 5®. In contrast, the HI was smaller with the PSG than Apnomonitor: 17.5 ± 11.1 for the PSG and 22.2 ± 11.5 for the Apnomonitor. There were no differences in any other sleep parameters (AHI, ODI, lowest SpO2) between the
Discussion
Respiration was monitored using the standard PSG and Apnomonitor 5® with the identical methodology, including a pulse oximetry, an oronasal thermistor, a microphone for the tracheal sound, a positional sensor, and chest and abdominal circumferences. Therefore, the two methods exhibited nearly identical total numbers of apnea and hypopnea events and high correlations. The AI was estimated lower by approximately 10% with the Apnomonitor 5® (23.7 ± 22.1) than PSG (26.4 ± 23.0). However, the sleep time
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