Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Feb;17(2):MT13-9.
doi: 10.12659/msm.881379.

Evaluation of the accuracy of manual and automatic scoring of a single airflow channel in patients with a high probability of obstructive sleep apnea

Ahmed S BaHammam  1 , Munir Sharif, Divinagracia E Gacuan, Smitha George
Affiliations

Evaluation of the accuracy of manual and automatic scoring of a single airflow channel in patients with a high probability of obstructive sleep apnea

Ahmed S BaHammam et al. Med Sci Monit. 2011 Feb.

Abstract

Background: ApneaLink (AL) is a single-channel type-4 device that measures airflow. A limited number of studies have assessed AL's usefulness in diagnosing obstructive sleep apnea (OSA) using automated scoring alone. This study was conducted to assess the sensitivity and specificity of AL in a selected group of people with clinical suspicion of OSA, using both automatic and manual scoring and comparing the results with those obtained for polysomnography (PSG).

Material/methods: Simultaneous overnight recordings of in-laboratory PSG and AL were performed for 95 patients (mean age 46.3 ± 12.6 yr) with a high clinical suspicion of OSA. PSG was scored manually according to the American Academy of Sleep Medicine (AASM) guidelines. AL data were analyzed automatically using a manufacturer-provided computerized algorithm. Manual scoring of the AL flow signal followed the AASM guidelines for reduction in flow.

Results: The mean apnea hypopneas index (AHI) for PSG was 34.1 ± 32.4/hr. The AL Auto-AHI was 20.1 ± 25.2/h, and the AL Manual-AHI was 39.5 ± 30.4/h. The Pearson correlation coefficients were r=0.883 between PSG-AHI and AL Auto-AHI, and r=0.966 between PSG-AHI and AL Manual-AHI. At AHIs of 5, 10, 15, and 30, the AL Auto sensitivity/specificity was 0.79/0.68, 0.70/0.89, 0.64/0.94 and 0.63/0.98, and the AL Manual sensitivity/specificity was 1.00/0.43, 1.00/0.56, 0.98/0.58 and 1.00/0.80.

Conclusions: Combining auto and manual scoring of data (automatic scoring followed by manual scoring) recorded by single-channel ApneaLink provides good diagnostic agreement with conventional PSG recordings.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A correlation analysis between (A) PSG AHI and AL Auto AHI and (B) PSG AHI and AL Manual AHI.
Figure 2
Figure 2
A Bland-Altman agreement plot for (A) AL Auto AHI and PSG AHI and (B) AL Manual AHI and PSG AHI. The dotted lines are the mean difference ±1.96 SD. The continuous line represents the identity line.
Figure 3
Figure 3
ROC curves with PSG AHI cut-off values of 5, 10, 15 and 30 for both AL Auto and AL Manual with the corresponding area under the curve (AUC).
See this image and copyright information in PMC

References

    1. Schahin SP, Nechanitzky T, Dittel C, et al. Long-term improvement of insulin sensitivity during CPAP therapy in the obstructive sleep apnoea syndrome. Med Sci Monit. 2008;14(3):CR117–21. - PubMed
    1. Tkacova R, Dorkova Z, Molcanyiova A, et al. Cardiovascular risk and insulin resistance in patients with obstructive sleep apnea. Med Sci Monit. 2008;14(9):CR438–44. - PubMed
    1. Selim B, Won C, Yaggi HK. Cardiovascular consequences of sleep apnea. Clin Chest Med. 2010;31(2):203–20. - PubMed
    1. Bahammam AS, Aljafen B. Sleep medicine service in Saudi Arabia. A quantitative assessment. Saudi Med J. 2007;28(6):917–21. - PubMed
    1. Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997;20(9):705–6. - PubMed

Publication types