BACKGROUND: Portable sleep apnea monitors are often used to screen for sleep-disordered breathing in chronic heart failure patients (CHF), but night-to-night repeatability of obtained measurements of nocturnal breathing disorders has not been fully assessed. METHODS: Fifty-six stable, moderate-to-severe CHF patients [male, 87%; age, 57 ± 9 years; NYHA class, 2.6 ± 0.6; left ventricular ejection fraction (LVEF), 32% ± 9%] underwent an unattended in-hospital cardiorespiratory recording using a portable sleep apnea monitor during two consecutive nights. The apnea/hypopnea index (AHI), apnea index (AI), oxygen desaturation index (ODI), and periodic breathing (PB) duration were computed. Intra-subject night-to-night variability was assessed by the 95% limits of random variation (LoV). We also estimated the contribution of intra-rater variability to the overall intra-subject variability. Dichotomizing the AHI and PB duration according to conventional cutoffs of, respectively, ≥5 events per hour, ≥15 events per hour, and ≥120 min, the percentage of patients concordantly classified by the two measurements was finally computed. RESULTS: The 95% LoV were ±10.6, ±7.7, ±11.3 events per hour for AHI, AI and ODI, and ±63.2 min for PB duration, respectively. The contribution of intra-rater variability to total intra-subject variability was 1.7%, 1.4%, 2.5%, and 1.3% for AHI, AI, ODI, and PB duration, respectively. Most patients (85%, 82%, and 95% for AHI ≥ 5, AHI ≥ 15, and PB duration, respectively) were classified concordantly by the two measurements. CONCLUSIONS: In patients with heart failure, measurements of severity of sleep-disordered breathing derived from portable sleep apnea monitors show significant night-to-night intra-subject variation with a negligible contribution from intra-rater variability; however, using the same measurements for classification purposes, as commonly performed in clinical practice to screen patients for sleep-disordered breathing, very stable results are obtained.
BACKGROUND: Portable sleep apnea monitors are often used to screen for sleep-disordered breathing in chronic heart failurepatients (CHF), but night-to-night repeatability of obtained measurements of nocturnal breathing disorders has not been fully assessed. METHODS: Fifty-six stable, moderate-to-severe CHFpatients [male, 87%; age, 57 ± 9 years; NYHA class, 2.6 ± 0.6; left ventricular ejection fraction (LVEF), 32% ± 9%] underwent an unattended in-hospital cardiorespiratory recording using a portable sleep apnea monitor during two consecutive nights. The apnea/hypopnea index (AHI), apnea index (AI), oxygen desaturation index (ODI), and periodic breathing (PB) duration were computed. Intra-subject night-to-night variability was assessed by the 95% limits of random variation (LoV). We also estimated the contribution of intra-rater variability to the overall intra-subject variability. Dichotomizing the AHI and PB duration according to conventional cutoffs of, respectively, ≥5 events per hour, ≥15 events per hour, and ≥120 min, the percentage of patients concordantly classified by the two measurements was finally computed. RESULTS: The 95% LoV were ±10.6, ±7.7, ±11.3 events per hour for AHI, AI and ODI, and ±63.2 min for PB duration, respectively. The contribution of intra-rater variability to total intra-subject variability was 1.7%, 1.4%, 2.5%, and 1.3% for AHI, AI, ODI, and PB duration, respectively. Most patients (85%, 82%, and 95% for AHI ≥ 5, AHI ≥ 15, and PB duration, respectively) were classified concordantly by the two measurements. CONCLUSIONS: In patients with heart failure, measurements of severity of sleep-disordered breathing derived from portable sleep apnea monitors show significant night-to-night intra-subject variation with a negligible contribution from intra-rater variability; however, using the same measurements for classification purposes, as commonly performed in clinical practice to screen patients for sleep-disordered breathing, very stable results are obtained.
Authors: P A Lanfranchi; A Braghiroli; E Bosimini; G Mazzuero; R Colombo; C F Donner; P Giannuzzi Journal: Circulation Date: 1999-03-23 Impact factor: 29.690
Authors: R Maestri; G D Pinna; E Robbi; M Varanini; M Emdin; M Raciti; M T La Rovere Journal: Comput Methods Programs Biomed Date: 2002-05 Impact factor: 5.428
Authors: Ali Vazir; Peter C Hastings; Ioannis Papaioannou; Philip A Poole-Wilson; Martin R Cowie; Mary J Morrell; Anita K Simonds Journal: Respir Med Date: 2008-03-17 Impact factor: 3.415
Authors: Neil R Ward; Vitor Roldao; Martin R Cowie; Stuart D Rosen; Theresa A McDonagh; Anita K Simonds; Mary J Morrell Journal: Sleep Date: 2013-09-01 Impact factor: 5.849
Authors: Jennifer N Miller; Paula Schulz; Bunny Pozehl; Douglas Fiedler; Alissa Fial; Ann M Berger Journal: Sleep Breath Date: 2017-11-14 Impact factor: 2.816
Authors: Eman S-D Khalil; Ehab I Mohamed; Gihane I Khalil; Samera M Sallam; Shaimaa S Mohamed; Salah S Naga; Mohamed N Mowafy Journal: Sleep Breath Date: 2012-06-09 Impact factor: 2.816
Authors: Dominik Linz; Mathias Baumert; Lien Desteghe; Kadhim Kadhim; Kevin Vernooy; Jonathan M Kalman; Dobromir Dobrev; Michael Arzt; Manu Sastry; Harry J G M Crijns; Ulrich Schotten; Martin R Cowie; R Doug McEvoy; Hein Heidbuchel; Jeroen Hendriks; Prashanthan Sanders; Dennis H Lau Journal: Int J Cardiol Heart Vasc Date: 2019-10-18