Can We Use Home Sleep Testing for the Evaluation of Sleep Apnea in Obese Pregnant Women?

الملخص EN

Objective.

To evaluate the performance of a type III home sleep testing (HST) monitor including its autoscoring algorithm, in a population of obese pregnant women.

Methods.

This was an ancillary study of an ongoing prospective study of obese (BMI of ≥30) pregnant women.

For the primary study, women undergo serial in-lab polysomnograms (PSG) during pregnancy.

Sleep apnea was defined as an apnea hypopnea index (AHI) of ≥ 5 events/hour.

A subgroup of women were asked to wear an ApneaLink HST device for 1 night, within 2 weeks of a late pregnancy PSG (≥ 28 weeks’ gestation).

The AHI obtained from PSG was compared to the AHI from the HST via autoscoring (HST-auto) as well as the AHI via technician scoring (HST-tech).

We calculated Shrout Fleiss Fixed correlation coefficients (ICC) and looked at positive-positive and negative-negative agreement.

Results.

43 women were recruited and we obtained 30 valid HST.

The mean PSH AHI was 3.3 (±3.2, range 0.5-16.6).

Six (20%) women had a positive PSG study.

ICCs were 0.78 for HST-auto versus HST-tech, 0.76 for HST-auto versus PSG, and 0.70 for HST-tech versus PSG.

Categorical agreement was also strong, with 24/30 (80.0%) for HST-auto versus HST-tech, 25/30 (83.3%) for HST-auto versus PSG, and 23/30 (76.7%) for HST-tech versus PSG.

Conclusion.

In obese women evaluated in late pregnancy, we found relatively high intraclass correlation and categorical agreement among HST-auto scores, HST-tech scores, and in-lab PSG results obtained within a two-week window.

These results suggest that HST may be used to screen pregnant women for OSA.