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Validation of a photoplethysmography device for detection of obstructive sleep apnea in the perioperative setting

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Abstract

Obstructive sleep apnea (OSA) is a risk factor for perioperative complications, but many OSA patients present undiagnosed. While polysomnography (PSG) is the “gold standard” for diagnosis, its application is technology-intense, time-consuming, expensive, and requires specialists, often delaying surgery. Thus, miniaturized devices were developed for OSA screening aimed at ruling out major OSA while measuring a lesser number of biological signals. We evaluated the accuracy of a photoplethysmography (PPG)-based device for OSA detection. 48 patients with established or strongly suspected (STOP-Questionnaire) OSA scheduled for surgery underwent in their preoperative nights parallel recordings by PPG and a classic polygraphy (PG) devices (SomnoLab2®). We compared the diagnostic accuracy of the PPG in diagnosing mild [Apnea-/Hypopnea-Index (AHI) 5–14 events/h] and moderate-to-severe OSA (AHI > 15). PPG and PG-derived AHI correlated significantly (r = 0.85, p < 0.0001) and high area under curve (AUC) in receiver operator characteristics (ROC) values were seen for both AHI thresholds (0.93 and 0.95, respectively). For an AHI > 5, sensitivity was 100%, specificity 44%, positive predictive value (PPV) 62%, negative predictive value (NPV) 100%, likelihood ratio (LHR) 1.79, and Cohen κ was 0.43. For an AHI > 15, sensitivity was 92%, specificity 77%, PPV 60%, NPV 96%, LHR 4.04, and Cohen κ was 0.59. In a typical perioperative cohort of confirmed and suspected OSA patients, PPG reliably detected OSA patients while showing some false-positive results. Such devices are helpful for preoperative OSA screening.

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Acknowledgements

We thank Weinmann Geräte für Medizin GmbH & Co. KG, Hamburg, Germany, for supporting this study by lending us five portable polygraphy devices.

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Authors and Affiliations

  1. Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen and Universitätsklinikum Essen, Hufelandstr 55, 45147, Essen, Germany

    Philipp Faßbender, Ali Haddad, Silja Bürgener & Jürgen Peters

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  1. Philipp Faßbender
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  2. Ali Haddad
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  4. Jürgen Peters
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Correspondence to Philipp Faßbender.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Faßbender, P., Haddad, A., Bürgener, S. et al. Validation of a photoplethysmography device for detection of obstructive sleep apnea in the perioperative setting. J Clin Monit Comput 33, 341–345 (2019). https://doi.org/10.1007/s10877-018-0151-2

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  • DOI: https://doi.org/10.1007/s10877-018-0151-2

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