Overnight pulse oximetry for sleep-disordered breathing in adults - A review

Walter Reed National Military Medical Center, Washington, Washington, D.C., United States
Chest (Impact Factor: 7.13). 09/2001; 120(2):625-33. DOI: 10.1378/chest.120.2.625
Source: PubMed

ABSTRACT Pulse oximetry is a well-established tool routinely used in many settings of modern medicine to determine a patient's arterial oxygen saturation and heart rate. The decreasing size of pulse oximeters over recent years has broadened their spectrum of use. For diagnosis and treatment of sleep-disordered breathing, overnight pulse oximetry helps determine the severity of disease and is used as an economical means to detect sleep apnea. In this article, we outline the clinical utility and economical benefit of overnight pulse oximetry in sleep and breathing disorders in adults and highlight the controversies regarding its limitations as presented in published studies.

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    • "PSG is treated as the gold standard for the diagnosis of OSA; however, it has several limitations, such as technical expertise is required and timely access is restricted [11]. Thus, home pulse oximetry has been proposed as a valuable and effective tool for screening patients with OSA; nonetheless, it's efficacy in OSA diagnosis has been debated for several years [12]. Recently, a comprehensive evaluation of representative oxyhemoglobin indices for predicting severity of OSA was reported [13]. "
    Applied Mathematics & Information Sciences 02/2015; 9(1L). DOI:10.12785/amis/091L19 · 1.23 Impact Factor
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    • "Time spent below 90% Netzer et al. [16] Expert systems Daniels et al. [17] Delta-index Lévy et al. [18], Olson et al. [19], and Magalang et al. [20] Spectral analysis Zamarrón et al. [21] [22], Hua and Yu [23], and Morillo et al. [24] "
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    ABSTRACT: Automatic diagnosis of the Sleep Apnea-Hypopnea Syndrome (SAHS) has become an important area of research due to the growing interest in the field of sleep medicine and the costs associated with its manual diagnosis. The increment and heterogeneity of the different techniques, however, make it somewhat difficult to adequately follow the recent developments. A literature review within the area of computer-assisted diagnosis of SAHS has been performed comprising the last 15 years of research in the field. Screening approaches, methods for the detection and classification of respiratory events, comprehensive diagnostic systems, and an outline of current commercial approaches are reviewed. An overview of the different methods is presented together with validation analysis and critical discussion of the current state of the art.
    01/2015; 2015(8). DOI:10.1155/2015/237878
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    • "One subject reported diagnosed sleep apnoea, although he presented with an average of three desaturation events per hour, as determined by two nights of pulse oximetry. Given a threshold of 15 desaturation events has been linked to abnormal apnoea–hypopnoea indices (Netzer et al. 2001), the subject was included in the current study. Eight subjects (Control n = 5, MetSyn n = 3) were taking a daily vitamin supplement. "
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    ABSTRACT: Young healthy adults exhibit an inverse linear relationship between muscle sympathetic nerve activity (MSNA) and α-adrenergic responsiveness. This balance may be reversed in metabolic syndrome (MetSyn) given animal models exhibit increased sympathetic activity and α-mediated vasoconstriction. We hypothesized humans with MetSyn would demonstrate increased α-adrenergic vasoconstriction and the inverse relationship between MSNA and adrenergic responsiveness would be lost. We measured MSNA (microneurography of the peroneal nerve) and forearm blood flow (FBF, Doppler ultrasound) in 16 healthy control subjects (31±3 years) and 14 adults with MetSyn (35±3 years; p>0.05) during local administration of α-adrenergic agonists (phenylephrine, PE α1; clonidine, CL α2). MSNA was greater in MetSyn subjects when compared with healthy controls (p<0.05). A group difference in vasoconstriction to PE was not detected (p=0.08). The level of α1-mediated vasoconstriction was inversely related to MSNA in control subjects (r=0.5, p=0.04); this balance between MSNA and α1-responsiveness was lost in adults with MetSyn. MetSyn subjects exhibited greater vasoconstriction to CL infusion when compared with healthy controls (p<0.01). A relationship between MSNA and α2-mediated vasoconstriction was not detected in either group. In summary, altered neurovascular control in human MetSyn is receptor-specific. The observed uncoupling between MSNA and α1-adrenergic responsiveness and increased α2 -vasoconstriction may lead to reduced FBF, altered flow distribution, and/or severe hypertension with the progression toward diabetes and cardiovascular disease.
    The Journal of Physiology 10/2012; 590(23). DOI:10.1113/jphysiol.2012.239780 · 4.54 Impact Factor
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