1. Efficacy of Home Single-Channel Nasal Pressure for Recommending Continuous Positive Airway Pressure Treatment in Sleep Apnea
- Author
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Masa, Juan F., Duran-Cantolla, Joaquin, Capote, Francisco, Cabello, Marta, Abad, Jorge, Garcia-Rio, Francisco, Ferrer, Antoni, Fortuna, Ana M., Gonzalez-Mangado, Nicolas, de la Peña, Monica, Aizpuru, Felipe, Barbe, Ferran, Montserrat, Jose M., Larrateguy, Luis D., de Castro, Jorge Rey, Garcia-Ledesma, Estefania, Corral, Jaime, Martin-Vicente, Maria J., Martinez-Null, Cristina, Egea, Carlos, Cancelo, Laura, García-Díaz, Emilio, Carmona-Bernal, Carmen, Sánchez-Armengol, Ángeles, Mayos, Merche, Miralda, Rosa M, Troncoso, Maria F., Gonzalez, Monica, Martinez-Martinez, Marian, Cantalejo, Olga, Piérola, Javier, Vigil, Laura, Embid, Cristina, del Mar Centelles, Mireia, Prieto, Teresa Ramírez, Rojo, Blas, and Lores, Vanesa
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,portable monitor ,medicine.medical_treatment ,Polysomnography ,Apnealink ,Nose ,Young Adult ,CPAP ,Physiology (medical) ,Internal medicine ,medicine ,Pressure ,Humans ,Continuous positive airway pressure ,Aged ,Aged, 80 and over ,Sleep Apnea, Obstructive ,Receiver operating characteristic ,medicine.diagnostic_test ,Continuous Positive Airway Pressure ,business.industry ,Home Single-Channel Nasal Pressure for Recommending CPAP Treatment ,Area under the curve ,Sleep apnea ,Middle Aged ,sleep apnea ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Clinical trial ,Obstructive sleep apnea ,medicine.anatomical_structure ,Editorial ,ROC Curve ,Anesthesia ,Area Under Curve ,Female ,Neurology (clinical) ,business - Abstract
Introduction Unlike other prevalent diseases, obstructive sleep apnea (OSA) has no simple tool for diagnosis and therapeutic decision-making in primary healthcare. Home single-channel nasal pressure (HNP) may be an alternative to polysomnography for diagnosis but its use in therapeutic decisions has yet to be explored. Objectives To ascertain whether an automatically scored HNP apnea-hypopnea index (AHI), used alone to recommend continuous positive airway pressure (CPAP) treatment, agrees with decisions made by a specialist using polysomnography and several clinical variables. Methods Patients referred by primary care physicians for OSA suspicion underwent randomized polysomnography and HNP. We analyzed the total sample and both more and less symptomatic subgroups for Bland and Altman plots to explore AHI agreement; receiver operating characteristic curves to establish area under the curve (AUC) measurements for CPAP recommendation; and therapeutic decision efficacy for several HNP AHI cutoff points. Results Of the 787 randomized patients, 35 (4%) were lost, 378 (48%) formed the more symptomatic and 374 (48%) the less symptomatic subgroups. AHI bias and agreement limits were 5.8 ± 39.6 for the total sample, 5.3 ± 38.7 for the more symptomatic, and 6 ± 40.2 for the less symptomatic subgroups. The AUC were 0.826 for the total sample, 0.903 for the more symptomatic, and 0.772 for the less symptomatic subgroups. In the more symptomatic subgroup, 70% of patients could be correctly treated with CPAP. Conclusion Automatic HNP scoring can correctly recommend CPAP treatment in most of more symptomatic patients with OSA suspicion. Our results suggest that this device may be an interesting tool in initial OSA management for primary care physicians, although future studies in a primary care setting are necessary. Clinical trials information Clinicaltrial.gov identifier: NCT01347398.
- Published
- 2015