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Primary care diagnosis of sleep apnoea syndrome in the Girona Healthcare area

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Introduction: Diagnosing sleep apnoea syndrome (SAS) in hospital settings limits detection and is costly. We compare SAS diagnosis in primary care (PC) by respiratory polygraphy with automatic analysis (RPa) with… Click to show full abstract

Introduction: Diagnosing sleep apnoea syndrome (SAS) in hospital settings limits detection and is costly. We compare SAS diagnosis in primary care (PC) by respiratory polygraphy with automatic analysis (RPa) with currently validated methodology and hospital techniques. Material and methods: Random, cross-sectional, single-blind, multicentre study at four primary care centres and their reference hospital over 6 months. Patients between 30 and 70 years with high probability of SAS (STOP-BANG ≥3) who were visited at their primary care centre were included. Apnealink Air respiratory polygraphy was performed at home and read by the primary care doctor. Recorded data were sent online to the reference hospital and analysed manually by a sleep specialist. In patients with non-severe SAS (Apnoea-Hypopnoea Index Results: 76.2% (48/63) of patients completed the protocol; mean age 57.5±8.5; male sex 62.5%; BMI 30.5±5.8. 85.4% were diagnosed with RPa. Concordance between PC and hospital diagnosis was k=0.22 (Table 1). For severity, patients with SAS had a concordance of k=0.54 with a sensitivity of 45.4%; 95% CI (11.5-79.4), specificity of 100.0%; 95% CI (98.3-100.0), PPV 100.0% and NPV 83.3% (Table 2). Conclusion: RPa could be useful in diagnosing SAS in PC. Hospital diagnosis would not be needed in cases of severe SAS.

Keywords: diagnosis; apnoea syndrome; primary care; hospital; care; sleep apnoea

Journal Title: European Respiratory Journal
Year Published: 2017

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