Evaluation of peripheral arterial tonometry for outpatient sleep medicine diagnostics of an otorhinolaryngology tertiary referral center

Since the development and scientific validation of peripheral arterial tonometry regarding relevant target parameters of sleep diagnostics, an equivalent alternative to ambulatory polygraphy has been established in recent years. However, many aspects of the method remain unclear, as the validation of the system focused on the apnoea-hypopnoea index (AHI), the main classifying parameter of sleep apnea. The present study is a retrospective analysis of the peripheral arterial tonometry after the introduction of tonometry as a standard of outpatient sleep diagnostics at the Otorhinolaryngology Department of the University of Göttingen Medical Center (UMG). Since the introduction of the method, about 300 patients have been examined at the UMG. The sample is mainly divided into two large subgroups: On the one hand, these are patients with a high pre-test probability for a sleep-related breathing disorder and tonometry is applied to confirm the suspected diagnosis. On the other hand, the method was used in cases of known sleep-related breathing disorder for re-evaluation or follow-up. The results initially show a high rate of valid measurements. Operating errors on the part of the patients were rare. For the subgroups examined, good correlations with clinical parameters were found, especially for position-dependent findings. In contrast, the comparison with external polygraphy and polysomnography showed mixed results. In summary, peripheral arterial tonometry is also suitable for routine outpatient sleep diagnostics in the context of an tertiary Otolaryngology department. Existing disadvantages are counterbalanced by a high proportion of valid measurements regarding initial diagnosis, therapy evaluation and follow-up.