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Vol. 41. Issue 2.
Pages 71-77 (February 2005)
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Vol. 41. Issue 2.
Pages 71-77 (February 2005)
Original Articles
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Validation of a Respiratory Polygraphy System in the Diagnosis of Sleep Apnea Syndrome
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A. Candelaa,
Corresponding author
candela_alf@gva.es

Correspondence: Dr. A. Candela. Servicio de Neumología. Hospital General Universitario de Alicante. PintorBaeza, s/n. 03010 Alicante. España
, L. Hernándeza, S. Asensioa, J. Sánchez-Payáb, J. Vilaa, N. Benitoa, S. Romeroa
a Servicio de Neumología, Hospital General Universitario de Alicante, Alicante, Spain
b Servicio de Medicina Preventiva, Hospital General Universitario de Alicante, Alicante, Spain
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Objective

To validate a cardiorespiratory polygraphy system (BITMED NGP 140) by comparing it to conventional polysomnography in the diagnosis of sleep apnea-hypopnea syndrome.

Patients and methods

Polysomnography and cardiorespiratory polygraphy were performed simultaneously on 103 consecutive patients referred because of suspected sleep apnea-hypopnea syndrome. The Bland and Altman method and intraclass correlation coefficients were used to assess agreement between the 2 methods of measurement. Receiver operating characteristic (ROC) curves were used to calculate the yield of cardiorespiratory polygraphy compared to that of conventional polysomnography.

Results

Ninety-two valid studies were obtained for 72 men and 20 women (mean [SD] age: 52.4 [12] years). By the Bland and Altman method, the difference between the respiratory event index obtained with the BITMED NGP140 and the apnea-hypopnea index (AHI) obtained by conventional polysomnography was 7.6 (13.2) in the manual analysis (95% confidence interval [CI], 4.9-10.4) and 12 (15.3) (95% CI, 8.8-15.3) in the automatic analysis. For a corrected AHI (AH/total time in bed) mean differences were -2.2 (5.9) and 2.4 (8.2) for manual and automatic analyses. The intraclass correlation coefficients were greater than 0.94.

The areas under the ROC curves of the respiratory event index were greater than 0.97 for all cut points. For an AHI of 30 or higher, the best cut-off point determined by manual cardiorespiratory polygraphy analysis was 27 (sensitivity, 98% and specificity, 98%). For the different cut-off points cardiorespiratory polygraphy correctly classified between 92% and 98% of patients in both the manual and automatic analyses.

Conclusions

The BITMED NGP140 had good agreement with conventional polysomnography for the measurement of respiratory events and provided high diagnostic yield.

Key Words:
Sleep apnea
Polysomnography
Polygraphy
Validation study
Sensitivity
Specificity
Objetivo

Validar un dispositivo de poligrafía (PGR) cardiorrespiratoria, BITMED NGP140, frente a la polisomno-grafía convencional (PSG) en el síndrome de apneas e hipopneas durante el sueño.

Pacientes Y Métodos

Se realizó PSG y, simultáneamente, PGR a 103 pacientes consecutivos enviados por sospecha de síndrome de apneas e hipopneas durante el sueño. Se aplicaron el método de Bland y Altman, y el coeficiente de correlación intraclase para analizar la concordancia de los 2 dispositivos. La rentabilidad diagnóstica de la PGR frente a la PSG se calculó mediante las curvas de eficacia diagnóstica.

Resultados

Se obtuvieron 92 estudios válidos, en 72 varones y 20 mujeres con una media de edad (± desviación estándar) de 52,4 ± 12 años. Con el método de Bland y Altman la diferencia del índice de eventos respiratorios del BITMED NGP140 con el índice de apneashipopneas (IAH) de la PSG era, en el análisis manual, de 7,6 ± 13,2 (intervalo de confianza del 95%, 4,9-10,4), y en el análisis automático, de 12 ± 15,3 (intervalo de confianza del 95%, 8,8-15,3), mientras que para el IAH corregido (IAH/tiempo total de registro) la media de la diferencia fue de -2,2 ± 5,9 en el análisis manual y de 2,4 ± 8,2 en el automático. Las correlaciones intraclase eran superiores a 0,94.

Las áreas bajo la curva de eficacia diagnóstica del índice de eventos respiratorios eran superiores a 0,97 en todos los puntos de corte. Para un IAH de 30 o superior, el mejor punto de corte del análisis manual de la PGR era de 27 (sensibilidad del 98% y especificidad del 98%). Para los diferentes puntos de corte, la PGR clasificaba correctamente entre el 92 y el 98% de los pacientes tanto con el análisis manual como con el automático.

Conclusiones

El BITMED NGP140 tiene una buena concordancia con la PSG en la medición de los eventos respiratorios y ofrece un alto rendimiento diagnóstico.

Palabras clave:
Apneas durante el sueño
Polisomnografía
Poligrafía
Estudio de validación
Sensibilidad
Especificidad
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This study was funded by the Office of Health Technology Assessment, Department of Health, Government of the Autonomous Community of Valencia (Generalitat) (Project No. 006/2001).

Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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