A wrist-worn oximetry in the detection of obstructive sleep apnea in stroke patients

Abstract

Objective: To assess the accuracy of a Dehaier wrist pulse oximeter DHR998 Plus to detect obstructive sleep apnea (OSA) in stroke patients.

Methods: One hundred and fifty-one ischemic stroke patients simultaneously completed a standard polysomnogram (PSG) and wore the Dehaier wrist pulse oximeter DHR998 Plus and another finger-worn oximetry Pulsox-300i during a nocturnal recording. PSG sleep and apnea-hypopnea index (AHI) were scored according to AASM criteria. Dehaier wrist pulse oximeter DHR998 Plus and Pulsox-300i data were analyzed with an automated computerized algorithm which calculated the amount of oxygen desaturation events with a 4% decline from baseline lasting more than 3 seconds per hour. This yielded an oxygen desaturation index 4% (ODI4). Agreement analysis and receiver operator characteristic curve analysis were used to measure the diagnostic reliability of Dehaier wrist pulse oximeter DHR998 Plus compared with AHI and Plusox-300i.

Results: Among the 151 patients, 14 cases were without OSA (AHI<5), 25 cases were diagnosed with mild OSA (AHI:5-14.9), 29 cases were diagnosed with moderate OSA (AHI:15-29.9) and 83 cases were diagnosed with severe OSA (AHI≥30). There was a significant correlation between Dehaier wrist pulse oximeter DHR998 Plus derived ODI4 and AHI (r=0.74, P<0.01). The agreement between Dehaier wrist pulse oximeter DHR998 Plus derived ODI4 and Pulsox-300i derived ODI4 was moderately good, with interclass correlation coefficient (ICC) values of 0.83 (95% CI, 0.78-0.88, P<0.01). To assess sensitivity and specificity of Dehaier wrist pulse oximeter DHR998 Plus, we constructed receiver operator characteristic curve by various AHI threshold values (5, 15, 20 and 30). Optimal combinations of sensitivity and specificity for the various thresholds were 0.88/0.71, 0.88/0.69, 0.93/0.65, 0.74/0.9, respectively.

Conclusions: Wrist-worn Dehaier wrist pulse oximeter DHR998 Plus can detect OSA with reasonable reliability as Gravel V2, especially for severe OSA in stroke patients.