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SUBJECT OBJECTIVE: To assess the accuracy of a portable monitoring device based on peripheral arterial tonometry to diagnose obstructive sleep apnea (OSA). To propose a new standard for limited-channel device validation using synchronized polysomnography (PSG) home recordings and a population-based cohort. DESIGN: Single-night, unattended PSG and WatchPAT 100 (WP₁00). SETTING: Home environment. PARTICIPANTS: Ninety-eight subjects (55 men; age, 60 +/- 7 year; body mass index, 28 +/- 4 kg/m2) consecutively recruited from the Skaraborg Hypertension and Diabetes Project. MEASUREMENTS AND RESULTS: The WP₁00 records peripheral arterial tone, heart rate, oxygen saturation and actigraphy for automatic analysis of respiratory disturbance index (RDI), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and sleep-wake state. The accuracy of WP₁00 in RDI, AHI, ODI, and sleep-wake detection was assessed by comparison with data from simultaneous PSG recordings. The mean PSG-AHI in this population was 25. 5 +/- 22. 9 events per hour. The WP₁00 RDI, AHI, and ODI correlated closely (0. 88, 0. 90, and 0. 92; p <. 0001, respectively) with the corresponding indexes obtained by PSG. The areas under the curve for the receiver-operator characteristic curves for WP₁00 AHI and RDI were 0. 93 and 0. 90 for the PSG-AHI and RDI thresholds 10 and 20 (p <. 0001, respectively). The agreement of the sleep-wake assessment based on 30-second bins between the 2 systems was 82 +/- 7%. CONCLUSIONS: The WP₁00 was reasonably accurate for unattended home diagnosis of OSA in a population sample not preselected for OSA symptoms. The current design, including simultaneous home PSG recordings in population-based cohorts, is proposed as a reasonable validation standard for assessment of simplified recording tools for OSA diagnosis.
Zou et al. (Wed,) studied this question.