%0 Journal Article
%T Indication of CPAP in Patients with Suspected Obstructive Sleep Apnea, Based on Clinical Parameters and a Novel Two-Channel Recording Device (ApneaLink): A Pilot Study
%A Carlos Alberto Nigro
%A Eduardo Dibur
%A Sof¨ªa Grandval
%A Facundo Nogueira
%J Sleep Disorders
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/346181
%X Objective. To evaluate the accuracy and reliability of the medical decision based on the results of the hand scoring from a two-channel recording device (ApneaLink) plus clinical data for the prescription of a CPAP assay in patients with suspected OSA. Methods. 39 subjects were assessed in the sleep laboratory with polysomnography and ApneaLink. The patients completed the Epworth sleepiness scale and a clinical history. Two blinded independent observers decided to prescribe CPAP according to the results of the PSG (gold standard, observer A), ApneaLink (alternative method, observer B), and the clinical parameters. Sensitivity and specificity of observer B on the indication of CPAP were calculated. The interobserver agreement for the indication of CPAP was assessed using kappa statistics. Results. 38 subjects were included (26 men, mean age 47.5, mean RDI 28.7, mean BMI 31.4£¿kg/m2). The prevalence of OSA was 84%. The sensitivity and specificity of observer B to initiate a CPAP trial were 90.6% and 100%, respectively. The interrater agreement for the prescription of CPAP was good (kappa: 0.75). Conclusion. This study has shown that the use of ApneaLink plus clinical data has made it possible to indicate CPAP reliably in most patients with high-clinical pretest for OSA. 1. Introduction Obstructive sleep apnea (OSA) is a major health problem due to its prevalence rates of 2¨C4% in middle-aged people [1] and significant morbidity [2, 3] and mortality [4] reported in patients with this condition. Continuous positive airway pressure (CPAP) is an effective treatment commonly prescribed for symptomatic patients with obstructive sleep apnea. It is costeffective [5] and reduces daytime sleepiness [6], rates of motor vehicle accidents [7], and blood pressure [8]. The American Thoracic Society [9] and the American Academy of Sleep Medicine [10] recommend supervised polysomnography (PSG) in the sleep laboratory over two nights for the diagnosis of obstructive sleep apnea and initiation of CPAP. This approach to a highly prevalent condition results in inevitable discrepancies between the demand for services and the current capacity of sleep laboratories [11]. Because the treatment of sleep apnea provides many benefits to patients and society, it is imperative to develop strategies that are less complex than the traditional approach based on PSG to expedite the diagnosis and treatment of patients with OSA. The ApneaLink is a two-channel screening tool for sleep apnea. The device consists of a nasal cannula attached to a small case that houses a pressure transducer and a
%U http://www.hindawi.com/journals/sd/2012/346181/