Abstract
Introduction
Respiratory polygraphy (RP) is frequently used as an alternative to polysomnography (PSG) for the diagnosis of sleep disordered breathing (SDB). However, recommendations for the scoring of RP recordings are still lacking. Pulse-wave amplitude (PWA) drops, considered as surrogates for microarousals, may provide a better definition of respiratory events for PM recordings.
Aims and objectives
To investigate the performance of four different hypopnea scoring criteria for the diagnosis of SDB using 3% or 4% oxygen desaturation, including or not PWA drops in RP recordings compared to home full PSG
Methods
Subjects from a population-based cohort (HypnoLaus) underwent a complete home PSG. The PSG recordings were then rescored using only the parameters available on RP with "lights off" and "lights on" based on patients' report instead of EEG. The AHI of the four different RP scoring criteria were then compared to the PSG-based AHI.
Results
312 subjects were included. Overall, RP-AHIs showed a good correlation with PSG-AHI although it tended to slightly underestimated it. The PG-AHI using 3% desaturation without PWA criteria showed the best diagnostic accuracy for AHI thresholds of ≥5/h and ≥15/h (correctly classifying 94.6% and 93.3% of subjects respectively). For AHI ≥30/h however, the inclusion of PWA drops showed better accuracy (classifying correctly 94.2% subjects).
Conclusions
Interpretation of RP recordings using hypopnea criteria which include 3% desaturation without PWA drops showed the best correlation and diagnosis accuracy for mild and moderate SDB. Using PWA drops as surrogates for microarousals adds accuracy for the detection of severe SDB.
- © 2014 ERS