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Efficacy of home single-channel nasal pressure for recommending continuous positive airway pressure treatment in sleep apnea

Abstract: Introduction: Unlike other prevalent diseases, obstructive sleep apnea (OSA) has no simple tool for diagnosis and therapeutic decision-making in primary healthcare. Home single-channel nasal pressure (HNP) may be an alternative to polysomnography for diagnosis but its use in therapeutic decisions has yet to be explored. Objectives: To ascertain whether an automatically scored HNP apnea-hypopnea index (AHI), used alone to recommend continuous positive airway pressure (CPAP) treatment, agrees with decisions made by a specialist using polysomnography and several clinical variables. Methods: Patients referred by primary care physicians for OSA suspicion underwent randomized polysomnography and HNP. We analyzed the total sample and both more and less symptomatic subgroups for Bland and Altman plots to explore AHI agreement; receiver operating characteristic curves to establish area under the curve (AUC) measurements for CPAP recommendation; and therapeutic decision efficacy for several HNP AHI cutoff points. Results: Of the 787 randomized patients, 35 (4%) were lost, 378 (48%) formed the more symptomatic and 374 (48%) the less symptomatic subgroups. AHI bias and agreement limits were 5.8 ± 39.6 for the total sample, 5.3 ± 38.7 for the more symptomatic, and 6 ± 40.2 for the less symptomatic subgroups. The AUC were 0.826 for the total sample, 0.903 for the more symptomatic, and 0.772 for the less symptomatic subgroups. In the more symptomatic subgroup, 70% of patients could be correctly treated with CPAP. Conclusion: Automatic HNP scoring can correctly recommend CPAP treatment in most of more symptomatic patients with OSA suspicion. Our results suggest that this device may be an interesting tool in initial OSA management for primary care physicians, although future studies in a primary care setting are necessary.

 Fuente: Sleep . 2015 Jan 1;38(1):13-21

Editorial: Oxford University Press

 Año de publicación: 2015

Nº de páginas: 9

Tipo de publicación: Artículo de Revista

 DOI: 10.5665/sleep.4316

ISSN: 0161-8105,1550-9109

Url de la publicación: https://doi.org/10.5665/sleep.4316

Autores/as

MASA, JUAN F.

DURAN CANTOLLA, JOAQUIN

CAPOTE, FRANCISCO

MARTA CABELLO NAJERA

ABAD, JORGE

GARCIA RIO, FRANCISCO

FERRER, ANTONI

FORTUNA, ANA M.

GONZALEZ MANGADO, NICOLÁS

PEÑA, MONICA DE LA

AIZPURU, FELIPE

BARBE, FERRAN

MONTSERRAT, JOSE M.

SPANISH SLEEP NETWORK