Artificial Intelligence in Medicine
Volume 41, Issue 1 , Pages 13-24 , September 2007

Improving diagnostic ability of blood oxygen saturation from overnight pulse oximetry in obstructive sleep apnea detection by means of central tendency measure

  • Daniel Álvarez

      Affiliations

    • E.T.S.I. de Telecomunicación, University of Valladolid, Camino del Cementerio s/n, 47011 Valladolid, Spain
    • Corresponding Author InformationCorresponding author. Tel.: +34 983 423000x5589; fax: +34 983 423661.
    • ,
  • Roberto Hornero

      Affiliations

    • E.T.S.I. de Telecomunicación, University of Valladolid, Camino del Cementerio s/n, 47011 Valladolid, Spain
    • ,
  • María García

      Affiliations

    • E.T.S.I. de Telecomunicación, University of Valladolid, Camino del Cementerio s/n, 47011 Valladolid, Spain
    • ,
  • Félix del Campo

      Affiliations

    • Hospital del Río Hortega, Servicio de Neumología, c/Cardenal Torquemada s/n, 47010 Valladolid, Spain
    • ,
  • Carlos Zamarrón

      Affiliations

    • Hospital Clínico Universitario, Servicio de Neumología, Travesía de la Choupana s/n, 15706 Santiago de Compostela, Spain

Received 18 October 2006 ,Revised 29 May 2007 ,Accepted 12 June 2007.

References 

  1. Guilleminault C, Tilkian A, Dement WC. The sleep apnea syndromes. Ann Rev Med. 1976;27:464–484
  2. Guilleminault C, Van Den Hoed J, Mitler MM. Clinical overview of the sleep apnea syndromes. In:  Gilleminault C,  Dement WC editor. Sleep apnea syndromes. New York: Alan R. Liss; 1978;
  3. Douglas NJ. Recent advances in the obstructive sleep apnoea/hypopnoea syndrome. Ann Acad Med. 2002;31:697–701
  4. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea. Am J Resp Crit Care. 2002;165:1217–1239
  5. Day R, Gerhardstein R, Lumley A, Roth T, Rosenthal L. The behavioral morbidity of obstructive sleep apnea. Prog Cardiovasc Dis. 1999;41:341–354
  6. Agency for Health Care Policy and Research (AHCPR). Systematic Review of the Literature Regarding the Diagnosis of Sleep Apnea: Summary, Evidence Report/Technology Assessment. Department of Health and Human Services (U.S. Public Health Service), 1999, No. 1, vol. E002.
  7. Flemons WW, Littner MR, Rowlet JA, Gay P, Anderson WM, Hudgel DW, et al. Home diagnosis of sleep apnea: a systematic review of the literature. Chest. 2003;124:1543–1579
  8. Epstein LJ, Dorlac GR. Cost-effectiveness analysis of nocturnal oximetry as a method of screening for sleep apnea–hypopnea syndrome. Chest. 1998;113:97–103
  9. Sano K, Nakano H, Ohnishi Y, Ishii Y, Nakamura T, Matuzawa K, et al. Screening of sleep apnea–hypopnea syndrome by home pulse oximetry. Nihon Kokyuki Gakkai Zasshi. 1998;36:948–952
  10. Chiner E, Signes-Costa J, Arriero JM, Marco J, Fuentes I, Sergado A. Nocturnal oximetry for the diagnosis of the sleep apnoea hypopnoea syndrome: a method to reduce the number of polysomnographies?. Thorax. 1999;54:968–971
  11. Nuber R, Varvrina J, Karrer W. Predictive value of nocturnal pulse oximetry in sleep apnea screening Schweiz. Med Wschr (Suppl). 2000;116:120S–122S
  12. Chaudhary B, Dasti S, Park Y, Brown T, Davis H, Akhtar B. Hour-to-hour variability of oxygen saturation in sleep apnea. Chest. 1998;113:719–722
  13. Golpe R, Jimenez A, Carpizo R, Cifrian JM. Utility of home oximetry as a screening test for patients with moderate to severe symptoms of obstructive sleep apnea. Sleep. 1999;22:932–937
  14. Magalang UJ, Dmochowski J, Veeramachaneni S, Draw A, Mador MJ, El-Solh A, et al. Prediction of the apnea–hypopnea index from overnight pulse oximetry. Chest. 2003;124:1694–1701
  15. Netzer N, Eliasson AH, Netzer C, Kristo DA. Overnight pulse oximetry for sleep-disordered breathing in adults. Chest. 2001;120:625–633
  16. Del Campo F, Hornero R, Zamarrón C, Abásolo D, Álvarez D. Oxygen saturation regularity analysis in the diagnosis of obstructive sleep apnea. Artif Intell Med. 2006;37:111–118
  17. Zamarrón C, Hornero R, del Campo F, Abásolo D, Álvarez D. Heart rate regularity analysis obtained from pulse oximetric recordings in the diagnosis of obstructive sleep apnea. Sleep Breath. 2006;10:83–89
  18. Álvarez D, Hornero R, Abásolo D, del Campo F, Zamarrón C. Nonlinear characteristics of blood oxygen saturation from nocturnal oximetry for obstructive sleep apnoea detection. Physiol Meas. 2006;27:399–412
  19. Cohen ME, Hudson DL, Deedwania PC. Applying continuous chaotic modeling to cardiac signals. IEEE Eng Med Biol. 1996;15:97–102
  20. Burioka N, Cornélissen G, Halberg F, Kaplan DT, Suyama H, Sako T, et al. Approximate entropy of human respiratory movement during eye-closed waking and different sleep stages. Chest. 2003;123:80–86
  21. Caldirola D, Bellodi L, Caumo A, Migliarese G, Perna G. Approximate entropy of respiratory patterns in panic disorder. Am J Psychiatry. 2004;161:79–87
  22. Rechtschaffen A, Kales A. A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Washington, DC: US Government Printing Office, National Institutes of Health Publication; 1968;
  23. Zamarrón C, Romero PV, Rodríguez JR, Gude F. Oximetry spectral analysis in the diagnosis of obstructive sep apnoea. Clin Sci. 1999;97:467–473
  24. Zamarrón C, Gude F, Barcala J, Rodríguez JR, Romero PV. Utility of oxygen saturation and heart rate spectral analysis obtained from pulse oximetric recordings in the diagnosis of sleep apnea syndrome. Chest. 2003;123:1567–1576
  25. Zamarrón C, Pichel F, Romero PV. Coherence between oxygen saturation and heart rate obtained from pulse oximetric recordings in obstructive sleep apnoea. Physiol Meas. 2005;26:799–810
  26. Meoli AL, Casey KR, Clark RW, Coleman JA, Fayle RW, Troell RJ, et al. Clinical practice review committee Hypopnea in sleep-disordered breathing in adults. Sleep. 2001;24:469–470
  27. American Academy of Sleep Medicine Task Force (AASM) . Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep. 1999;22:667–689
  28. Global Initiative for Chronic Obstructive Lung Disease (GOLD) . Global strategy for the diagnosis management and prevention of chronic obstructive pulmonary disease, NHI Publication 2701. Bethesda: National Health, Lung and Blood Institute (NHLBI/WHO); 2001;p. 1–100
  29. Warley ARH, Mitchell JH, Stradling JR. Evaluation of the Ohmeda 3700 pulse oximeter. Thorax. 1987;42:892–896
  30. Lévy P, Pépin JL, Deschaux-Blanc C, Paramelle B, Brambilla C. Accuracy of oximetry for detection of respiratory disturbances in sleep apnea syndrome. Chest. 1996;109:395–399
  31. Gyulay S, Olson LG, Hensley MJ, King MT, Murree Allen K, Saunders NA. A comparison of clinical assessment and home oximetry in the diagnosis of obstructive sleep apnea. Am Rev Respir Dis. 1993;147:50–53
  32. Pincus SM. Assessing serial irregularity and its implications for health. Ann NY Acad Sci. 2001;954:245–267
  33. Pincus SM, Goldberger AL. Physiological time-series analysis: what does regularity quantify?. Heart Circ Physiol. 1994;35:H1643–H1656
  34. Pincus SM. Approximate Entropy as a measure of system complexity. Proc Natl Acad Sci USA. 1991;88:2297–2301
  35. Jeong J, Gore JC, Peterson BS. A method for determinism in short time series, and its applications to stationary EEG. IEEE Trans Biomed Eng. 2002;49:1374–1379
  36. Rodriguez JM, de Lucas P, Sánchez MJ, Izquierdo JL, Peraita R, Cubillo JM. Usefulness of the visual analysis of night oximetry as a screening method in patients with suspected clinical sleep apnea syndrome. Arch Bronconeumol. 1996;32:437–441
  37. Lacassagne L, Didier A, Murris-Espin M, Charlet JP, Chollet P, Leophonte-Domairon ML, et al. Role of nocturnal oximetry in screening for sleep apnea syndrome in pulmonary medicine: study of 329 patients. Rev Mal Respir. 1997;14:201–207
  38. Ryan PJ, Hilton MF, Boldy DA, Evans A, Bradbury S, Sapiano S, et al. Validation of British Thoracic Society guidelines for the diagnosis of the sleep apnoea/hypopnea syndrome: can polysomnography by avoided?. Thorax. 1995;50:972–975
  39. Brouillette RT, Morielli A, Leimanis A, Waters KA, Luciano R, Ducharme FM. Nocturnal pulse oximetry as an abbreviated testing modality for pediatric obstructive sleep apnea. Pediatrics. 2000;105:405–412
  40. Olson LG, Ambrogetti A, Gyulay SG. Prediction of sleep-disordered breathing by unattended overnight oximetry. J Sleep Res. 1999;8:51–55
  41. Wiltshire N, Kendrick A, Catterall J. Home oximetry studies for diagnosis of sleep apnea/hypopnea syndrome: limitation of memory storage capabilities. Chest. 2001;120:384–389
  42. Farré R, Montserrat JM, Rotger M, Ballester E, Navajas D. Accuracy of thermistors and thermocouples as flow-measuring devices for detecting hypopneas. Eur Respir J. 1998;11:179–182
  43. Montserrat JM, Farré R, Ballester E, Félez MA, Pasto M, Navajas D. Evaluation of nasal prongs for estimating nasal flow. Am J Respir Crit Care Med. 1997;155:211–215
  44. Sériès F, Marc I. Nasal pressure recording in the diagnosis of sleep apnoea hypopnoea syndrome. Thorax. 1999;54:506–510
  45. Flemons WW, Littner MR. Measuring agreement between diagnostic devices. Chest. 2003;124:1535–1542
  46. Whitelaw WA, Brant RF, Flemons WW. Clinical usefulness of home oximetry compared with polysomnography for assessment of sleep apnea. Am J Respir Crit Care Med. 2005;171:188–193
  47. Masa JF, Corral J, Martín MJ, Riesco JA, Sojo A, Hernández M, et al. Assessment of thoracoabdominal bands to detect respiratory effort-related arousal. Eur Respir J. 2003;22:661–667

PII: S0933-3657(07)00071-1

doi: 10.1016/j.artmed.2007.06.002

Artificial Intelligence in Medicine
Volume 41, Issue 1 , Pages 13-24 , September 2007

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