Dados do Trabalho

Título

VALIDATION OF A PORTABLE MONITORING SYSTEM FOR THE DIAGNOSIS OF OBSTRUCTIVE SLEEP APNEIA IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE.

Introdução

Portable polysomnography (PSG) has been used to diagnose obstructive sleep apnea (OSA) in several populations. However, its use has not been validated in patients with chronic obstructive pulmonary disease (COPD) and OSA. The objective of the study was to validate portable PSG (ApneaLink plus ™, ResMed, San Diego, CA, USA) for the diagnosis of OSA in patients with COPD.

Objetivo

Validate portable PSG (ApneaLink plus ™, ResMed, San Diego, CA, USA) for OSA diagnosis in COPD patients.

Métodos

This is a cross-sectional validation study. Patients with COPD recruited at three reference centers were simultaneously submitted to PSG and portable PSG for the diagnosis of OSA. The high risk for OSA was verified by the Berlin, NoSAS and Stop-Bang questionnaires. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for the portable PSG for the 5, 15 and 30 events / hour apnea hypopnea index cut-offs (AHI), as well as for the questionnaires used. The Bland-Altman plot and correlation analysis between the PSG AHI and the portable PSG were also performed.

Resultados

A total of 62 patients (67.5 ± 12.5 years, 55% men) participated in the study. The Stop-Bang questionnaire presented the highest sensitivity [94.4 (72.7 - 99.9%)] for the diagnosis of OSA among the questionnaires. The sensitivity of portable PSG decreased and specificity increased as the AHI cut-off increased from 5, 15 and 30 events/hour (87.0%, 66.7% and 44.4% and 40.0%, 78.6% and 100.0% respectively). The Bland-Altman analysis indicated good acceptance limits (AHI = 5.5 ± 11.7 events / hour). The AHI of the portable PSG showed a strong and positive correlation with the PSG AHI (p <0.0001, r = 0.70).

Conclusões

This study demonstrated that portable PSG may be a useful equipment for the diagnosis of OSA in patients with COPD due to its ease of use and accuracy in diagnosis.

Palavras-chave

Chronic obstructive pulmonary disease, Obstructive sleep apnea, Validation studies.