Peripheral arterial tonometry demonstrated an 80% concordance with polysomnography in diagnosing obstructive sleep apnoea, with a concordance correlation coefficient of 0.595.
Cohort (n=940)
No
Does peripheral arterial tonometry accurately diagnose obstructive sleep apnoea compared to polysomnography, and do discordant diagnoses affect long-term cardiovascular risk?
Home sleep apnoea testing with peripheral arterial tonometry shows good diagnostic concordance with polysomnography, and patients with discordant results do not have a significantly different 3-year risk of major adverse cardiovascular events.
Effect estimate: CCC 0.595 (95% CI 0.557-0.663)
BACKGROUND: Polysomnography (PSG) is the gold standard for the diagnosis of obstructive sleep apnoea (OSA). Home sleep apnoea testing with peripheral arterial tonometry (PAT) is a recommended diagnostic alternative for patients with an increased risk for OSA. In a large clinical cohort, we investigated concordance and predictors for discordance in diagnosing OSA using PAT and PSG, and three-year cardiovascular risk in patients with discordant OSA diagnosis. METHODS: Retrospective monocentric cohort study. Patients with a PAT AHI ≥ 5/h followed by an in-hospital PSG within three months were included. All patients with a PAT AHI ≥ 5/h but a PSG AHI < 5/h were classified as discordant. Patients with PAT and PSG AHI ≥ 5/h were classified as concordant. To ascertain cardiovascular risk, major adverse cardiovascular events (MACE) were analyzed in discordant patients and sex, age, body mass index (BMI) and cardiovascular disease-matched concordant patients over a follow-up time of 3.1 ± 0.06 years. RESULTS: were included. Agreement in OSA diagnosis was observed in 80% of patients (55% in mild and 86% in moderate and severe OSA). Factors significantly associated with a discordant diagnosis were female sex, younger age and lower BMI, but not comorbidities. There was no significant difference in MACE (p = 0.920) between discordant patients (n = 155) and matched concordant patients (n = 274) with or without therapy. CONCLUSIONS: Concordance between PAT and PSG diagnosis of sleep apnoea is good, particularly in moderate and severe OSA. Predictors for discordant results between PAT and PSG were age, sex and BMI. MACE risk is similar in those with OSA diagnosed by PAT or PSG.
Röcken et al. (Sat,) conducted a cohort in Suspected obstructive sleep apnoea (n=940). Peripheral arterial tonometry (PAT) vs. Polysomnography (PSG) was evaluated on Concordance correlation coefficient for AHI (CCC 0.595, 95% CI 0.557-0.663). Peripheral arterial tonometry demonstrated an 80% concordance with polysomnography in diagnosing obstructive sleep apnoea, with a concordance correlation coefficient of 0.595.