Is portable monitoring accurate in the diagnosis of obstructive sleep apnea syndrome in chronic pulmonary obstructive disease?

Background: No scientific evidence supports the use of portable devices to diagnose obstructive sleep apnea syndrome (OSAS) in patients with co-morbities. Our aim was to evaluate the accuracy of a portable monitoring device (Stardust - STD) in the detection of patients with chronic obstructive pulmonary disease (COPD). Methods: Patients with COPD and clinical suspicion of OSAS were recruited for a prospective randomized study. The STD was used on two different nights: (1) at home (STDHome) and (2) at the sleep laboratory simultaneous with polysomnography (PSG-STDLab). Results: A total of 72 patients underwent the proposed recordings. Forty-six volunteers were excluded due to recording problems, and data from 26 subjects were analyzed. The mean age was (mean +/- SD) 62.8 +/- 8.5 years, 50% were male, and the mean forced expiratory volume in the first second was 55 +/- 11%. Significant intraclass correlation was observed between apnea-hypopnea index (AHI)-PSG vs. AHI-STDLab (r = 0.61, p < 0.0001) and AHI-STDHome (r = 0.47, p < 0.007). Kappa analysis also showed a significant agreement for severe group. Conclusion: Despite the agreement found in a small number of patients between AHI, a large number of failures in the recording limits the use of this portable device for the diagnosis of OSAS in patients with COPD. (C) 2012 Elsevier B.V. All rights reserved.