Ayal Romem1, Anat Romem2, Dafna Koldobskiy1, Steven M Scharf1. 1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland, Baltimore, MD. 2. Bouve College of Health Sciences, School of Nursing, Northeastern University, Boston, MA.
Abstract
OBJECTIVES: Increasing awareness of the high prevalence of obstructive sleep apnea (OSA) and its impact on health in conjunction with high cost, inconvenience, and short supply of in-lab polysomnography (PSG) has led to the development of more convenient, affordable, and accessible diagnostic devices. We evaluated the reliability and accuracy of a single-channel (finger pulse-oximetry) photoplethysmography (PPG)-based device for detection of OSA (Morpheus Ox). METHODS: Among a cohort of 73 patients referred for in-laboratory evaluation of OSA, 65 were simultaneously monitored with the PPG based device while undergoing PSG. Among these, 19 had significant cardiopulmonary comorbidities. Using the PSG as the "gold standard," the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), as well as the positive likelihood ratio (+LR) for an apnea hypopnea index (AHI)PSG > 5/h and AHIPSG > 15/h were calculated for the PPG. RESULTS: Valid results were available for 65 subjects. Mean age: 52.1 ± 14.2, Male: 52%, and BMI: 36.3 ± 9.7 kg/m(2). Positive correlation was found between PPG-derived and PSG-derived AHI (r = 0.81, p < 0.001). For AHIPSG > 5/h, sensitivity was 80%, specificity 86%, PPV 93%, NPV 68%, and +LR was 5.9. For AHIPSG > 15/h, sensitivity was 70%, specificity 91%, PPV 80%, NPV 85%, and +LR was 7.83. The corresponding areas under the receiver operator curves were 0.91 and 0.9. CONCLUSIONS: PPG-derived data compare well with simultaneous in-lab PSG in the diagnosis of suspected OSA among patients with and without cardiopulmonary comorbidities. CITATION: Romem A; Romem A; Koldobskiy D; Scharf SM. Diagnosis of obstructive sleep apnea using pulse oximeter derived photoplethysmographic signals.
OBJECTIVES: Increasing awareness of the high prevalence of obstructive sleep apnea (OSA) and its impact on health in conjunction with high cost, inconvenience, and short supply of in-lab polysomnography (PSG) has led to the development of more convenient, affordable, and accessible diagnostic devices. We evaluated the reliability and accuracy of a single-channel (finger pulse-oximetry) photoplethysmography (PPG)-based device for detection of OSA (Morpheus Ox). METHODS: Among a cohort of 73 patients referred for in-laboratory evaluation of OSA, 65 were simultaneously monitored with the PPG based device while undergoing PSG. Among these, 19 had significant cardiopulmonary comorbidities. Using the PSG as the "gold standard," the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), as well as the positive likelihood ratio (+LR) for an apnea hypopnea index (AHI)PSG > 5/h and AHIPSG > 15/h were calculated for the PPG. RESULTS: Valid results were available for 65 subjects. Mean age: 52.1 ± 14.2, Male: 52%, and BMI: 36.3 ± 9.7 kg/m(2). Positive correlation was found between PPG-derived and PSG-derived AHI (r = 0.81, p < 0.001). For AHIPSG > 5/h, sensitivity was 80%, specificity 86%, PPV 93%, NPV 68%, and +LR was 5.9. For AHIPSG > 15/h, sensitivity was 70%, specificity 91%, PPV 80%, NPV 85%, and +LR was 7.83. The corresponding areas under the receiver operator curves were 0.91 and 0.9. CONCLUSIONS: PPG-derived data compare well with simultaneous in-lab PSG in the diagnosis of suspected OSA among patients with and without cardiopulmonary comorbidities. CITATION: Romem A; Romem A; Koldobskiy D; Scharf SM. Diagnosis of obstructive sleep apnea using pulse oximeter derived photoplethysmographic signals.
Authors: T Hori; Y Sugita; E Koga; S Shirakawa; K Inoue; S Uchida; H Kuwahara; M Kousaka; T Kobayashi; Y Tsuji; M Terashima; K Fukuda; N Fukuda Journal: Psychiatry Clin Neurosci Date: 2001-06 Impact factor: 5.188
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: Daniel J Gottlieb; Gayane Yenokyan; Anne B Newman; George T O'Connor; Naresh M Punjabi; Stuart F Quan; Susan Redline; Helaine E Resnick; Elisa K Tong; Marie Diener-West; Eyal Shahar Journal: Circulation Date: 2010-07-12 Impact factor: 29.690
Authors: Adam S Fein; Alexei Shvilkin; Dhaval Shah; Charles I Haffajee; Saumya Das; Kapil Kumar; Daniel B Kramer; Peter J Zimetbaum; Alfred E Buxton; Mark E Josephson; Elad Anter Journal: J Am Coll Cardiol Date: 2013-04-23 Impact factor: 24.094
Authors: Joaquín Durán-Cantolla; Felipe Aizpuru; Jose María Montserrat; Eugeni Ballester; Joaquín Terán-Santos; Jose Ignacio Aguirregomoscorta; Mónica Gonzalez; Patricia Lloberes; Juan Fernando Masa; Mónica De La Peña; Santiago Carrizo; Mercedes Mayos; Ferrán Barbé Journal: BMJ Date: 2010-11-24
Authors: Diego R Mazzotti; Diane C Lim; Kate Sutherland; Lia Bittencourt; Jesse W Mindel; Ulysses Magalang; Allan I Pack; Philip de Chazal; Thomas Penzel Journal: Physiol Meas Date: 2018-09-13 Impact factor: 2.833
Authors: Tomas Konecny; Jeffrey B Geske; Ondrej Ludka; Marek Orban; Peter A Brady; Muaz M Abudiab; Felipe N Albuquerque; Alexander Placek; Tomas Kara; Karine R Sahakyan; Bernard J Gersh; A Jamil Tajik; Thomas G Allison; Steve R Ommen; Virend K Somers Journal: Chest Date: 2015-06 Impact factor: 9.410
Authors: Peter H Charlton; Panicos A Kyriaco; Jonathan Mant; Vaidotas Marozas; Phil Chowienczyk; Jordi Alastruey Journal: Proc IEEE Inst Electr Electron Eng Date: 2022-03-11 Impact factor: 10.961