Abstract
Objective: To assess the correlation between respiratory sleep indices as measured by portable sleep testing using peripheral arterial tonometry (PAT) and respiratory sleep indices as measured by formal polysomnography (PSG). Thereby assess the validity of PAT devices as diagnostic tools for obstructive sleep apnea in the adult population.
Method: PubMed, MEDLINE, Cochrane Trial Registry (through 12/2011), and relevant article bibliographies were searched. Articles were assessed by 3 reviewers. Systematic review and meta-analysis of studies assessing correlation of respiratory sleep indices between PAT devices and PSG in adults (>18 years) was conducted. Included studies provided an r value for correlation.
Results: Eleven studies met inclusion criteria and had data suitable for pooling (775 patients). Of these, 10 studies were “blinded” in that PAT and PSG were conducted simultaneously in either the home or laboratory setting. One study contained 2 trial phases for the same patient group (n = 21), 1 laboratory and 1 home-based, which were analyzed separately. Overall correlation of respiratory sleep indices was high (r = .867, .836-.892, P < .001). Studies comparing respiratory disturbance index (RDI) had a combined r = .854 (.823-.880, P < .001), and those comparing apnea-hypopnea index (AHI) had a combined r = .890 (.833-.929, P < .001). Analysis of publication bias revealed a nonsignificant Egger’s regression intercept.
Conclusion: Respiratory indices calculated using PAT-based portable devices correlate well with those calculated from the scoring of formal PSG. The strength of this correlation is supported by the “blinded” nature of the majority of the included studies. This technology represents a viable alternative to PSG for confirmation of clinically suspected sleep apnea.
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