Accuracy of portable polygraphy for the diagnosis of sleep apnea in multiple system atrophy.
Sleep Medicine. 2014-04-01; 15(4): 476-479
DOI: 10.1016/j.sleep.2013.12.013
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1. Sleep Med. 2014 Apr;15(4):476-9. doi: 10.1016/j.sleep.2013.12.013. Epub 2014 Feb
21.
Accuracy of portable polygraphy for the diagnosis of sleep apnea in multiple
system atrophy.
Meissner WG(1), Flabeau O(2), Perez P(3), Taillard J(4), Marquant F(3), Dupouy
S(5), Tison F(6), Philip P(4), Ghorayeb I(7).
Author information:
(1)Centre de référence atrophie multisystématisée, CHU de Bordeaux, Pessac,
France; Service de Neurologie, CHU de Bordeaux, Pessac, France; Université de
Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France;
CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France.
Electronic address: .
(2)Service de Neurologie, CHU de Bordeaux, Pessac, France.
(3)CHU de Bordeaux, Unité de Soutien Méthodologique à la Recherche Clinique
(USMR), Pôle de santé publique, Bordeaux, France.
(4)Université Bordeaux, Sommeil, Attention et Neuropsychiatrie, USR 3413,
Bordeaux, France; CNRS, Sommeil, Attention et Neuropsychiatrie, USR 3413,
Bordeaux, France.
(5)Centre de référence atrophie multisystématisée, CHU de Bordeaux, Pessac,
France; Service de Neurologie, CHU de Bordeaux, Pessac, France.
(6)Centre de référence atrophie multisystématisée, CHU de Bordeaux, Pessac,
France; Service de Neurologie, CHU de Bordeaux, Pessac, France; Université de
Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France;
CNRS, Institut des Maladies Neurodégénératives, UMR 5293, Bordeaux, France.
(7)Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293,
Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293,
Bordeaux, France; Department of Clinical Neurophysiology, University Hospital
Bordeaux, France.
OBJECTIVE: To assess the diagnostic accuracy of portable polygraphy (PG) for the
detection of sleep apnea (SA) in multiple system atrophy (MSA).
METHODS: Thirty consecutive patients with probable MSA underwent PG (overnight
recording of nasal flow, thoracic/abdominal movements and pulse oximetry),
followed 4 weeks later by full polysomnography (PSG) (reference standard). The
accuracy of PG was first assessed using the same threshold as for PSG
(apnea-hypopnea index [AHI]≥5), then for all possible AHI thresholds using the
area under the receiver operating characteristics (AUROC) curve. Inter-rater
reliability of PG was assessed using the kappa coefficient.
RESULTS: Among 30 patients enrolled, seven were excluded for technical problems
on PG or PSG and 23 were included in the main analysis. Eight out of 23 had an
AHI≥5 on PSG. With the same threshold, sensitivity, specificity, positive and
negative predictive values of PG for the diagnosis of SA were 87.5% (95%
confidence interval: 47-99), 80% (52-96), 70% (35-93) and 92.3% (64-99),
respectively. The kappa between PG raters was 0.75 (0.49-1.00) indicating good
agreement. The AUROC was 0.93 (0.82-1.00). No association was found between sleep
and excessive daytime sleepiness questionnaires and SA.
CONCLUSION: Portable PG seems to be valuable for ruling out SA in MSA.
Copyright © 2014 Elsevier B.V. All rights reserved.
DOI: 10.1016/j.sleep.2013.12.013
PMID: 24656908 [Indexed for MEDLINE]