Accuracy of ECG-based screening for sleep-disordered breathing: a survey of all male workers in a transport company.
Sleep Breath
; 17(1): 243-51, 2013 Mar.
Article
en En
| MEDLINE
| ID: mdl-22430527
ABSTRACT
PURPOSE:
Sleep-disordered breathing (SDB) is associated with increased risk for cardiovascular morbidity and mortality and for sleepiness-related accidents, but >75 % of the patients remain undiagnosed. We sought to determine the diagnostic accuracy of ECG-based detection of SDB when used for population-based screening.METHODS:
All male workers, mostly truck drivers, of a transport company (n = 165; age, 43 ± 12 years) underwent standard attended overnight polysomnography. Cyclic variation of heart rate (CVHR), a characteristic pattern of heart rate associated with SDB, was detected from single-lead ECG signals during the polysomnography by a newly developed automated algorithm of autocorrelated wave detection with adaptive threshold (ACAT).RESULTS:
Among 165 subjects, the apnea-hypopnea index (AHI) was ≥5 in 62 (38 %), ≥15 in 26 (16 %), and ≥30 in 16 (10 %). The number of CVHR per hour (CVHR index) closely correlated with AHI [r = 0.868 (95 % CI, 0.825-0.901)]. The areas under the receiver operating characteristic curves for detecting subjects with AHI ≥5, ≥15, and ≥30 were 0.796 (95 % CI, 0.727-0.855), 0.974 (0.937-0.993), and 0.997 (0.971-0.999), respectively. With a predetermined criterion of CVHR index ≥15, subjects with AHI ≥15 were identified with 88 % sensitivity and 97 % specificity (likelihood ratios for positive and negative test, 30.7 and 0.12). The classification performance was retained in subgroups of subjects with obesity, hypertension, diabetes mellitus, dyslipidemia, and decreased autonomic function.CONCLUSIONS:
The CVHR obtained by the ACAT algorithm may provide a useful marker for screening for moderate-to-severe SDB among apparently healthy male workers.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Síndromes de la Apnea del Sueño
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Accidentes de Trabajo
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Accidentes de Tránsito
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Tamizaje Masivo
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Polisomnografía
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Vehículos a Motor
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Electrocardiografía
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Enfermedades Profesionales
Tipo de estudio:
Diagnostic_studies
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Prognostic_studies
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Screening_studies
Límite:
Adult
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2013
Tipo del documento:
Article