Home monitoring for clinically suspected obstructive sleep apnea in pregnancy

• DOI: 10.5664/jcsm.10726
• Publication Date: 2023-07-24T15:00:20Z
• Authors: Jingyu Wang; Chi Zhang; Liyue Xu; Jun Wei; Jingjing Yang; Anna E. Strohl; Huijie Yi; Xinran Liu; Linyan Zhang; Rui Zhao; Shenda Hong; Bing Zhou; Long Zhao; Xueli Zhang; Xiaosong Dong; Kingman P. Strohl; Jianliu Wang; Guoli Liu; Fang Han
• Keywords: Sleep Apnea, Obstructive; Sleep Apnea Syndromes; Pregnancy; Polysomnography; Humans; Infant; Monitoring, Ambulatory; Female; Sleep; 3. Good health

To determine if a home sleep apnea test (HSAT) using a type III portable monitor (PM), Nox-T3 (Nox Medical, Inc., Reykjavik, Iceland), detects obstructive sleep apnea in pregnant women.Ninety-two pregnant women (34.5 ± 4.3 years; gestational age 25.4 ± 8.9 weeks; body mass index 29.9 ± 4.7 kg/m2) with suspected obstructive sleep apnea underwent HSAT with the Nox-T3 PM followed by overnight polysomnography (PSG) and PM recording simultaneously in the laboratory within 1 week. PMs were scored automatically and manually using a 3% criteria and compared with PSGs scored by following guidelines.Apnea-hypopnea indexes were 8.56 ± 10.42, 8.19 ± 13.79, and 8.71 ± 14.19 events/h on HSAT, in-laboratory PM recording, and PSG (P = .955), respectively. Bland-Altman analysis of the apnea-hypopnea index on PSG vs HSAT showed a mean difference (95% confidence interval) of -0.15 (-1.83, 1.53); limits of agreement (± 2 SD) were -16.26 to 16.56 events/h. Based on a threshold apnea-hypopnea index ≥ 5 events/h, HSAT had 91% sensitivity, 85% specificity, 84% positive-predictive value, and 92% negative-predictive value compared with PSG. When comparing the simultaneous recordings, closer agreement was observed. Automated vs manual analysis of PM showed no significant difference.A type III PM had an acceptable failure rate and high diagnostic performance operating as a reasonable alternative for in-laboratory PSG in pregnant women.Wang J, Zhang C, Xu L, et al. Home monitoring for clinically suspected obstructive sleep apnea in pregnancy. J Clin Sleep Med. 2023;19(11):1951-1960.