Validation of a photoplethysmography device for detection of obstructive sleep apnea in the perioperative setting.

Philipp Faßbender, Ali Haddad, Silja Bürgener, Jürgen Peters
Author Information
  1. Philipp Faßbender: Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Hufelandstr 55, 45147, Essen, Germany. philipp.fassbender@rub.de. ORCID
  2. Ali Haddad: Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Hufelandstr 55, 45147, Essen, Germany.
  3. Silja Bürgener: Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Hufelandstr 55, 45147, Essen, Germany.
  4. Jürgen Peters: Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Hufelandstr 55, 45147, Essen, Germany.

Abstract

obstructive sleep Apnea (OSA) is a risk factor for perioperative complications, but many OSA patients present undiagnosed. While polysomnography (PSG) is the "gold standard" for diagnosis, its application is technology-intense, time-consuming, expensive, and requires specialists, often delaying surgery. Thus, miniaturized devices were developed for OSA screening aimed at ruling out major OSA while measuring a lesser number of biological signals. We evaluated the accuracy of a photoplethysmography (PPG)-based device for OSA detection. 48 patients with established or strongly suspected (STOP-Questionnaire) OSA scheduled for surgery underwent in their preoperative nights parallel recordings by PPG and a classic polygraphy (PG) devices (SomnoLab2®). We compared the diagnostic accuracy of the PPG in diagnosing mild [Apnea-/Hypopnea-Index (AHI) 5-14 events/h] and moderate-to-severe OSA (AHI > 15). PPG and PG-derived AHI correlated significantly (r = 0.85, p < 0.0001) and high area under curve (AUC) in receiver operator characteristics (ROC) values were seen for both AHI thresholds (0.93 and 0.95, respectively). For an AHI > 5, sensitivity was 100%, specificity 44%, positive predictive value (PPV) 62%, negative predictive value (NPV) 100%, likelihood ratio (LHR) 1.79, and Cohen κ was 0.43. For an AHI > 15, sensitivity was 92%, specificity 77%, PPV 60%, NPV 96%, LHR 4.04, and Cohen κ was 0.59. In a typical perioperative cohort of confirmed and suspected OSA patients, PPG reliably detected OSA patients while showing some false-positive results. Such devices are helpful for preoperative OSA screening.

Keywords

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MeSH Term

Adult
Aged
Area Under Curve
Cohort Studies
Female
Humans
Male
Middle Aged
Monitoring, Physiologic
Oximetry
Perioperative Period
Photoplethysmography
Polysomnography
Predictive Value of Tests
ROC Curve
Reproducibility of Results
Sensitivity and Specificity
Sleep
Sleep Apnea, Obstructive
Surveys and Questionnaires

Word Cloud

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