Chest
Original Research: Sleep DisordersMisclassification of OSA Severity With Automated Scoring of Home Sleep Recordings
Section snippets
Study Sample
To accomplish the objectives of the current study, two type 3 devices (ApneaLink Plus [ResMed] and Embletta [Embla Systems]) were used for home sleep testing. A distinct study sample was recruited for each device. The first sample consisted of a community-based cohort of subjects (n = 100) between the ages of 21 and 80 years who did not have an established diagnosis of OSA at the time of enrollment and were not receiving OSA therapy. The second sample consisted of patients recruited from a
Results
The demographic and anthropometric variables along with the prevalence of various medical conditions assessed in the two study samples are shown inTable 1. Not surprisingly, the community-based sample was younger and less obese than the cardiology clinic sample. No differences were noted in the distribution of sex, race, or self-reported sleepiness (ie, Epworth Sleepiness Scale) between the two samples. Medical conditions such as hypertension, high cholesterol, myocardial infarction, and type 2
Discussion
The results of the current study demonstrate that agreement between automated and expert-reviewed manual scoring for type 3 home portable monitoring devices varies with the type of device and the specific metric (ie, AHI, ODI) used for the diagnosis of OSA. For the two devices examined, automated scoring consistently underestimated the AHI compared with manual scoring. This underestimation resulted in misclassification of OSA severity, specifically in those with mild to moderate disease.
Acknowledgments
Author contributions: N. M. P. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. R. N. A. contributed to the data collection, statistical analysis and interpretation, initial drafting of the manuscript, critical review of the manuscript for important intellectual content, and final approval of the manuscript; R. S. contributed to the data collection, critical review of the manuscript for important
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FUNDING/SUPPORT: This study was supported by grants from the National Institutes of Health [R01-HL075078, R01-HL117167, and K23-HL118414].
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