STUDY OBJECTIVES: To evaluate the accuracy and practicality of the Apnea Risk Evaluation System (ARES; Advanced Brain Monitoring; Carlsbad, CA), a limited-channel system for diagnosing sleep apnea/hypopnea in the home. DESIGN: Prospective randomized study with blinded analysis. SETTINGS: Two independent, community-based, sleep-disorders centers and the participants' homes. PARTICIPANTS: Two hundred ninety-nine subjects were recruited, including 210 consecutive willing patients referred by community physicians to the centers because of suspected sleep apnea; 36 "general medical" patients recruited from community physicians' offices; and 53 "presumably healthy" subjects recruited from community centers. MEASUREMENTS AND RESULTS:Manual scoring of attended in-laboratory full-night or split-night polysomnography by trained technologists supervised by physicians board certified in sleep medicine, and automated scoring of the limited-channel system used attended in the laboratory and unattended at home. The definition of the polysomnography apnea-hypopnea index (AHI) and the ARES respiratory disturbance index was the total number of events divided by the study duration in hours. Two hundred eighty-four valid comparisons of in-laboratory simultaneous polysomnography and ARES and 187 valid comparisons of in-laboratory polysomnography with a separate 2 nights of unattended self-applied ARES Unicorder (Advanced Brain Monitoring) were obtained. A diagnostic AHI cutoff of > 10 was used to establish the accuracy and validity of the ARES. The concurrent in-laboratory comparison yielded a sensitivity of 97.4, a specificity of 85.6, a positive predictive value of 93.6, and a negative predictive value of 93.9; in-home comparison sensitivity, specificity, positive predictive value, and negative predictive value were 91.5, 85.7, 91.5, and 85.7, respectively. CONCLUSIONS: The ARES demonstrated consistently high sensitivity and specificity for both in-laboratory and in-home recordings. In patients at risk for sleep apnea who do not a priori need an attended study, the ARES could provide a low-cost alternative to traditional polysomnography.
RCT Entities:
STUDY OBJECTIVES: To evaluate the accuracy and practicality of the Apnea Risk Evaluation System (ARES; Advanced Brain Monitoring; Carlsbad, CA), a limited-channel system for diagnosing sleep apnea/hypopnea in the home. DESIGN: Prospective randomized study with blinded analysis. SETTINGS: Two independent, community-based, sleep-disorders centers and the participants' homes. PARTICIPANTS: Two hundred ninety-nine subjects were recruited, including 210 consecutive willing patients referred by community physicians to the centers because of suspected sleep apnea; 36 "general medical" patients recruited from community physicians' offices; and 53 "presumably healthy" subjects recruited from community centers. MEASUREMENTS AND RESULTS: Manual scoring of attended in-laboratory full-night or split-night polysomnography by trained technologists supervised by physicians board certified in sleep medicine, and automated scoring of the limited-channel system used attended in the laboratory and unattended at home. The definition of the polysomnography apnea-hypopnea index (AHI) and the ARES respiratory disturbance index was the total number of events divided by the study duration in hours. Two hundred eighty-four valid comparisons of in-laboratory simultaneous polysomnography and ARES and 187 valid comparisons of in-laboratory polysomnography with a separate 2 nights of unattended self-applied ARES Unicorder (Advanced Brain Monitoring) were obtained. A diagnostic AHI cutoff of > 10 was used to establish the accuracy and validity of the ARES. The concurrent in-laboratory comparison yielded a sensitivity of 97.4, a specificity of 85.6, a positive predictive value of 93.6, and a negative predictive value of 93.9; in-home comparison sensitivity, specificity, positive predictive value, and negative predictive value were 91.5, 85.7, 91.5, and 85.7, respectively. CONCLUSIONS: The ARES demonstrated consistently high sensitivity and specificity for both in-laboratory and in-home recordings. In patients at risk for sleep apnea who do not a priori need an attended study, the ARES could provide a low-cost alternative to traditional polysomnography.
Authors: Nancy A Collop; Sharon L Tracy; Vishesh Kapur; Reena Mehra; David Kuhlmann; Sam A Fleishman; Joseph M Ojile Journal: J Clin Sleep Med Date: 2011-10-15 Impact factor: 4.062
Authors: Sina A Gharib; Amanda L Hurley; Michael J Rosen; James C Spilsbury; Amy E Schell; Reena Mehra; Sanjay R Patel Journal: Sleep Date: 2020-06-15 Impact factor: 5.849
Authors: Jin Woo Chung; Reyes Enciso; Daniel J Levendowski; Todd D Morgan; Philip R Westbrook; Glenn T Clark Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Endod Date: 2010-03-17
Authors: Sanjay R Patel; Jia Weng; Michael Rueschman; Katherine A Dudley; Jose S Loredo; Yasmin Mossavar-Rahmani; Maricelle Ramirez; Alberto R Ramos; Kathryn Reid; Ashley N Seiger; Daniela Sotres-Alvarez; Phyllis C Zee; Rui Wang Journal: Sleep Date: 2015-09-01 Impact factor: 5.849
Authors: Carmela Alcántara; Linda C Gallo; Jia Wen; Katherine A Dudley; Douglas M Wallace; Yasmin Mossavar-Rahmani; Daniela Sotres-Alvarez; Phyllis C Zee; Alberto R Ramos; Megan E Petrov; Melynda D Casement; Martica H Hall; Susan Redline; Sanjay R Patel Journal: Sleep Date: 2019-04-01 Impact factor: 5.849