0463 Validation of a Home Sleep Apnea Testing Device for the Diagnosis of Sleep Disordered Breathing based on AASM 2012 guidelines

• Published in: Sleep (New York, N.Y.) N.Y.), 2019-04, Vol.42 (Supplement_1), p.A186-A186
• Main Authors: Berry, Richard B, Purdy, Susan, Kantner, Greg, Blase, Amy, Javed, Faizan, Benjafield, Adam, Abreu, Alexandre
• Format: Article
• Language: English
• Subjects: Algorithms; Laboratories; Sleep apnea; Sleep disorders
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/zsz067.462

Introduction Home sleep apnea testing (HSAT) is a scalable, cost-effective way of diagnosing sleep disordered breathing (SDB) that can help address the volumes of undiagnosed patients due to limited availability of in-laboratory polysomnography (PSG) facilities. The American Academy of Sleep Medicine (AASM) in 2012 defined a hypopnea as a ≥ 30% drop in nasal air flow to pre-event baseline associated with either a ≥ 3% oxygen desaturation or an arousal. Most HSAT devices do not fully cover all aspects of the scoring rules and only score hypopneas associated with desaturations. The study aim was to evaluate the sensitivity and specificity (compared to PSG) of a new HSAT algorithm using hypopnea scoring using the AASM 2012 guidelines. Methods This was a dual-center, single-night study with simultaneous PSG and HSAT performed in 46 subjects referred to sleep laboratory for investigation of SDB. PSG studies were manually scored by a single expert sleep study scorer. The ApneaLink Air HSAT device (ResMed) uses an autoscoring algorithm that employs flow shape information and machine learning techniques to detect hypopnea associated with arousal. Studies were considered evaluable if the HSAT evaluation time was ≥ 4 hours. Results Subjects were predominantly male (65%), aged 56 ± 13 years, BMI 36 ± 8 kg/m2. Apnea-hypopnea Index (AHI, events/hr) categories per PSG reports were: 5 normal (AHI < 5), 9 mild SDB (AHI 5-14), 12 moderate SDB (AHI15-30) and 17 severe SDB (AHI≥30). Per PSG, there were 2,683 obstructive, 52 mixed, and 363 central apneas, and 5,324 hypopneas. Three subjects were excluded from the analysis due to low HSAT evaluation time. Sensitivity for the HSAT algorithm was 92% and specificity was 80% for ruling in SDB at AHI ≥ 5 when compared to manual expert PSG scoring. Conclusion The results from this study suggest that the new HSAT algorithm is suitable to screen for SDB based on AASM 2012 guidelines. Support (If Any) ResMed.