Screening of sleep apnea/hypopnea syndrome by home pulse oximetry

We evaluated the diagnostic accuracy and reproducibility of results obtained by home oximetry for the screening of sleep apnea/hypopnea syndrome. Our subjects were 40 patients who underwent home oximetry (12 patients for 1 night, 28 patients for 2 nights) followed by all-night polysomnography. Their mean age was 50.7 +/- 11.2 years; mean body mass index (BMI), 27.6 +/- 4.4 kg/m2; and mean apnea/hypopnea index (AHI), 36.0 +/- 26.0 hr-1. The data obtained by home pulse oximetry were fed into a personal computer, and utilized to calculate the desaturation cycles per hour (oxygen desaturation index (ODI) of 2-4%) and the percentage of time that SpO2 measured less than 90% (T 90). Polysomnography was used to monitor the number of apnea and hypopnea episodes per hour of sleep (AHI). With sleep apnea/hypopnea syndrome defined as AHI > or = 15, the diagnostic sensitivity and specificity of home pulse oximetry were 73.5% and 83.3%, respectively, when ODI-3 > or = 15 was used as the diagnostic standard. Patients who showed false negative results had a lower mean BMI (25.5 +/- 3.0) than those who showed true positive results (28.8 +/- 4.6). The reproducibility of ODI-3 data obtained at home was very high (r = 0.964, n = 28). In conclusion, home pulse oximetry seems to be a very useful tool for the detection of apnea/hypopnea syndrome, but false negative results should be considered a possibility, especially in patients who are not obese.