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. 2019 Aug 4:2019:3827579.
doi: 10.1155/2019/3827579. eCollection 2019.

Can We Use Home Sleep Testing for the Evaluation of Sleep Apnea in Obese Pregnant Women?

Francesca L Facco  1 , Victoria Lopata  1 , Jennifer M Wolsk  2 , Sanjay Patel  3 , Stephen R Wisniewski  2
Affiliations

Can We Use Home Sleep Testing for the Evaluation of Sleep Apnea in Obese Pregnant Women?

Francesca L Facco et al. Sleep Disord. .

Abstract

Objective: To evaluate the performance of a type III home sleep testing (HST) monitor including its autoscoring algorithm, in a population of obese pregnant women.

Methods: This was an ancillary study of an ongoing prospective study of obese (BMI of ≥30) pregnant women. For the primary study, women undergo serial in-lab polysomnograms (PSG) during pregnancy. Sleep apnea was defined as an apnea hypopnea index (AHI) of ≥ 5 events/hour. A subgroup of women were asked to wear an ApneaLink HST device for 1 night, within 2 weeks of a late pregnancy PSG (≥ 28 weeks' gestation). The AHI obtained from PSG was compared to the AHI from the HST via autoscoring (HST-auto) as well as the AHI via technician scoring (HST-tech). We calculated Shrout Fleiss Fixed correlation coefficients (ICC) and looked at positive-positive and negative-negative agreement.

Results: 43 women were recruited and we obtained 30 valid HST. The mean PSH AHI was 3.3 (±3.2, range 0.5-16.6). Six (20%) women had a positive PSG study. ICCs were 0.78 for HST-auto versus HST-tech, 0.76 for HST-auto versus PSG, and 0.70 for HST-tech versus PSG. Categorical agreement was also strong, with 24/30 (80.0%) for HST-auto versus HST-tech, 25/30 (83.3%) for HST-auto versus PSG, and 23/30 (76.7%) for HST-tech versus PSG.

Conclusion: In obese women evaluated in late pregnancy, we found relatively high intraclass correlation and categorical agreement among HST-auto scores, HST-tech scores, and in-lab PSG results obtained within a two-week window. These results suggest that HST may be used to screen pregnant women for OSA.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
(a)–(c) Scatterplots of AHI comparisons. (a) HST-auto vs. HST-tech, (b) HST-auto vs. PSG, and (c) HST-tech vs. PSG.
Figure 2
Figure 2
(a)–(c) Bland-Altman plots of AHI comparisons. (a) HST-auto vs. HST-tech, (b) HST-auto vs. PSG, and (c) HST-tech vs. PSG. Blue solid lines are a zero reference, red solid lines are the mean difference, dashed red lines represent the ±2 standard deviations from the mean, and dashed green line represents the ±3 standard deviations from the mean (for image resolution, given ranges, not all standard deviation lines were graphically presented).
See this image and copyright information in PMC

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