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Sleep Disorders
Volume 2013 (2013), Article ID 314589, 6 pages
http://dx.doi.org/10.1155/2013/314589
Research Article

Accuracy of Positive Airway Pressure Device—Measured Apneas and Hypopneas: Role in Treatment Followup

1Health Services Research & Development Unit, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
2Department of Medicine, University of California, San Diego, CA 92037, USA
3Pulmonary Service, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
4Department of Family and Preventive Medicine, University of California, San Diego, CA 92037, USA

Received 30 April 2013; Revised 16 July 2013; Accepted 19 July 2013

Academic Editor: Giora Pillar

Copyright © 2013 Carl Stepnowsky et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Improved data transmission technologies have facilitated data collected from positive airway pressure (PAP) devices in the home environment. Although clinicians’ treatment decisions increasingly rely on autoscoring of respiratory events by the PAP device, few studies have specifically examined the accuracy of autoscored respiratory events in the home environment in ongoing PAP use. “PAP efficacy” studies were conducted in which participants wore PAP simultaneously with an Embletta sleep system (Embla, Inc., Broomfield, CO), which was directly connected to the ResMed AutoSet S8 (ResMed, Inc., San Diego, CA) via a specialized cable. Mean PAP-scored Apnea-Hypopnea Index (AHI) was 14.2 ± 11.8 (median: 11.7; range: 3.9–46.3) and mean manual-scored AHI was 9.4 ± 10.2 (median: 7.7; range: 1.2–39.3). Ratios between the mean indices were calculated. PAP-scored HI was 2.0 times higher than the manual-scored HI. PAP-scored AHI was 1.5 times higher than the manual-scored AHI, and PAP-scored AI was 1.04 of manual-scored AI. In this sample, PAP-scored HI was on average double the manual-scored HI. Given the importance of PAP efficacy data in tracking treatment progress, it is important to recognize the possible bias of PAP algorithms in overreporting hypopneas. The most likely cause of this discrepancy is the use of desaturations in manual hypopnea scoring.