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CC BY-NC-ND 4.0 · Sleep Sci 2019; 12(02): 72-78
DOI: 10.5935/1984-0063.20190063
ORIGINAL ARTICLE

Predicting the night-to-night variability in the severity of obstructive sleep apnea: the case of the standard error of measurement

Eduardo Anitua
1   University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Sleep - Vitoria - Álava - Spain.
2   Clínica Eduardo Anitua, Sleep - Vitoria - Álava - Spain.
3   BTI Biotechnology Institute, Research and development - Vitoria - Álava - Spain
,
Joaquin Duran-Cantolla
1   University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Sleep - Vitoria - Álava - Spain.
2   Clínica Eduardo Anitua, Sleep - Vitoria - Álava - Spain.
4   Bioaraba Research Institute, OSI Araba University Hospital - Vitoria - Álava - Spain
5   Interdisciplinary Sleep Unit, OSI Araba University Hospital - Vitoria - Álava - Spain
6   Basque Country University, Medicine Department - Vitoria - Álava - Spain
7   Ciber de Enfermedades Respiratorias, (CIBERES) - Madrid - Madrid - Spain
,
Gabriela Zamora Almeida
2   Clínica Eduardo Anitua, Sleep - Vitoria - Álava - Spain.
,
Mohammad Hamdan Alkhraisat
1   University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Sleep - Vitoria - Álava - Spain.
3   BTI Biotechnology Institute, Research and development - Vitoria - Álava - Spain
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Study objectives Night-to-night variability in the apnea-hypopnea index (AHI) may affect the accuracy of the diagnosis of obstructive sleep apnea (OSA) and treatment selection. This study was conducted to assess the utility of the standard error of measurement (SEM) in predicting the night-to-night variability in the OSA.

Methods Ninety nine patients underwent a 3-consecutive nights of sleep monitoring with a validated home portable monitoring devise (BTI-APNiA, BTI Biotechnology Institute, Vitoria, Spain). The night-to-night variability in apnea- and hypopnea-related measures and blood desaturation were assessed. The agreement between the three nights was also assessed. The SEM and the AHI of the first night were used to calculate a range for the severity of the OSA. This range was then challenged to predict the most frequent OSA severity, the OSA severity in nights 2 and 3, and the OSA severity in the three nights.

Results Ninety nine patients (mean age: 56±14 years) participated in the study. The mean body mass index was 25.4±4.0 Kg/m2 and the mean score of Epworth questionnaire was 8±5. The AHI of the first, second and third nights were 13.96±13.46, 13.76±12.76 and 13.52±12.91 events/h, respectively. The night-to-night variability in the AHI and the sleep time in supine position over the three nights were not statistically significant. However, the differences in the severity of the OSA was statistically significant (range of agreement in the diagnosis: 41.7%-83.3%). The standard error of measurement (SEM) considering the AHI was 4.64 events/h.. The SEM was efficient in predicting the most frequent OSA severity (among the three nights) in more than 96% of the cases.

Conclusions The night-to-night variability in the AHI might affect the diagnosis of OSA. The use of standard error of measurement and the AHI of one single night would be of interest to predict the night-to-night variability in the severity of OSA.

Sleep - Sleep Apnea, Obstructive - Polysomnography - Respiratory Rate.


Publication History

Received: 17 September 2018

Accepted: 04 February 2019

Article published online:
31 October 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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