Predicting the night-to-night variability in the severity of obstructive sleep apnea: the case of the standard error of measurement

Study objectives: Night-to-night variability in the apnea-hypopnea index (AHI) may affect the accuracy of the diagnosis of obstructive sleep apnea (OSA) and treatment selection. This study was conducted to assess the utility of the standard error of measurement (SEM) in predi...

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Main Authors: Eduardo Anitua, Joaquin Duran-Cantolla, Gabriela Zamora Almeida, Mohammad Hamdan Alkhraisat
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2019-06-01
Series:Sleep Science
Subjects:
Online Access:http://sleepscience.org.br/export-pdf/606/ssci-12-02-0072.pdf
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author Eduardo Anitua
Joaquin Duran-Cantolla
Gabriela Zamora Almeida
Mohammad Hamdan Alkhraisat
author_facet Eduardo Anitua
Joaquin Duran-Cantolla
Gabriela Zamora Almeida
Mohammad Hamdan Alkhraisat
author_sort Eduardo Anitua
collection DOAJ
description Study objectives: Night-to-night variability in the apnea-hypopnea index (AHI) may affect the accuracy of the diagnosis of obstructive sleep apnea (OSA) and treatment selection. This study was conducted to assess the utility of the standard error of measurement (SEM) in predicting the night-to-night variability in the OSA. Methods: Ninety nine patients underwent a 3-consecutive nights of sleep monitoring with a validated home portable monitoring devise (BTI-APNiA, BTI Biotechnology Institute, Vitoria, Spain). The night-to-night variability in apnea- and hypopnea-related measures and blood desaturation were assessed. The agreement between the three nights was also assessed. The SEM and the AHI of the first night were used to calculate a range for the severity of the OSA. This range was then challenged to predict the most frequent OSA severity, the OSA severity in nights 2 and 3, and the OSA severity in the three nights. Results: Ninety nine patients (mean age: 56±14 years) participated in the study. The mean body mass index was 25.4±4.0 Kg/m2 and the mean score of Epworth questionnaire was 8±5. The AHI of the first, second and third nights were 13.96±13.46, 13.76±12.76 and 13.52±12.91 events/h, respectively. The night-to-night variability in the AHI and the sleep time in supine position over the three nights were not statistically significant. However, the differences in the severity of the OSA was statistically significant (range of agreement in the diagnosis: 41.7%- 83.3%). The standard error of measurement (SEM) considering the AHI was 4.64 events/h.. The SEM was efficient in predicting the most frequent OSA severity (among the three nights) in more than 96% of the cases. Conclusions: The night-to-night variability in the AHI might affect the diagnosis of OSA. The use of standard error of measurement and the AHI of one single night would be of interest to predict the night-to-night variability in the severity of OSA.
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spelling doaj.art-050cfa66c2fe4465b58081bc8f8d15172024-02-02T14:02:47ZengThieme Revinter Publicações Ltda.Sleep Science1984-06591984-00632019-06-01122727810.5935/1984-0063.20190063Predicting the night-to-night variability in the severity of obstructive sleep apnea: the case of the standard error of measurementEduardo Anitua0Joaquin Duran-Cantolla1Gabriela Zamora Almeida2Mohammad Hamdan Alkhraisat3University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Sleep - Vitoria - Álava - Spain.University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Sleep - Vitoria - Álava - Spain.Clínica Eduardo Anitua, Sleep - Vitoria - Álava - Spain.University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Sleep - Vitoria - Álava - Spain.Study objectives: Night-to-night variability in the apnea-hypopnea index (AHI) may affect the accuracy of the diagnosis of obstructive sleep apnea (OSA) and treatment selection. This study was conducted to assess the utility of the standard error of measurement (SEM) in predicting the night-to-night variability in the OSA. Methods: Ninety nine patients underwent a 3-consecutive nights of sleep monitoring with a validated home portable monitoring devise (BTI-APNiA, BTI Biotechnology Institute, Vitoria, Spain). The night-to-night variability in apnea- and hypopnea-related measures and blood desaturation were assessed. The agreement between the three nights was also assessed. The SEM and the AHI of the first night were used to calculate a range for the severity of the OSA. This range was then challenged to predict the most frequent OSA severity, the OSA severity in nights 2 and 3, and the OSA severity in the three nights. Results: Ninety nine patients (mean age: 56±14 years) participated in the study. The mean body mass index was 25.4±4.0 Kg/m2 and the mean score of Epworth questionnaire was 8±5. The AHI of the first, second and third nights were 13.96±13.46, 13.76±12.76 and 13.52±12.91 events/h, respectively. The night-to-night variability in the AHI and the sleep time in supine position over the three nights were not statistically significant. However, the differences in the severity of the OSA was statistically significant (range of agreement in the diagnosis: 41.7%- 83.3%). The standard error of measurement (SEM) considering the AHI was 4.64 events/h.. The SEM was efficient in predicting the most frequent OSA severity (among the three nights) in more than 96% of the cases. Conclusions: The night-to-night variability in the AHI might affect the diagnosis of OSA. The use of standard error of measurement and the AHI of one single night would be of interest to predict the night-to-night variability in the severity of OSA.http://sleepscience.org.br/export-pdf/606/ssci-12-02-0072.pdfsleepsleep apnea, obstructivepolysomnographyrespiratory rate
spellingShingle Eduardo Anitua
Joaquin Duran-Cantolla
Gabriela Zamora Almeida
Mohammad Hamdan Alkhraisat
Predicting the night-to-night variability in the severity of obstructive sleep apnea: the case of the standard error of measurement
Sleep Science
sleep
sleep apnea, obstructive
polysomnography
respiratory rate
title Predicting the night-to-night variability in the severity of obstructive sleep apnea: the case of the standard error of measurement
title_full Predicting the night-to-night variability in the severity of obstructive sleep apnea: the case of the standard error of measurement
title_fullStr Predicting the night-to-night variability in the severity of obstructive sleep apnea: the case of the standard error of measurement
title_full_unstemmed Predicting the night-to-night variability in the severity of obstructive sleep apnea: the case of the standard error of measurement
title_short Predicting the night-to-night variability in the severity of obstructive sleep apnea: the case of the standard error of measurement
title_sort predicting the night to night variability in the severity of obstructive sleep apnea the case of the standard error of measurement
topic sleep
sleep apnea, obstructive
polysomnography
respiratory rate
url http://sleepscience.org.br/export-pdf/606/ssci-12-02-0072.pdf
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