Strive for a Win-win Strategy on using Watch-PAT for screening Obstructive Sleep Apnea

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Authors (including presenting author) :
Yiu KC(1), Yau SY(1), Tsui KC(1), Hui SC(1), Sum YS(1), Abdullah V(1)(2)
Affiliation :
(1)Department of Ear, Nose & Throat, United Christian Hospital, Kowloon East Cluster, (2)Department of Otorhinolaryngology, The Chinese University of Hong Kong
Introduction :
Obstructive Sleep Apnea (OSA) is a common sleep-related disorder with the prevalence rate of 5% and 3% at middle-aged men and women respectively in Hong Kong, the untreated patients will encounter a higher risk of cardiovascular diseases. However, the situation of under-diagnosis and under-treatment for OSA is common; and one of the reasons which hampers patients to seek consultation may be the long waiting time for diagnosis prior to treatment. In this study, other alternative of home sleep study approach is deliberated.
Objectives :
This study aims at illustrating the accuracy of data acquisition from Watch-PAT alongside a full Polysomnography (PSG) during overnight sleep study for OSA assessment.
Methodology :
In 2010-2018, total 100 patients were recruited for a full PSG and Watch-PAT study on the same night at the Sleep Unit in United Christian Hospital (UCH). PSG study was scored according to the American Academy of Sleep Medicine (AASM) manual irrespective of the watch-PAT result and then analyzed by SPSS version 23.0 for comparison.
Result & Outcome :
The results of 100 patients (76 males vs 24 females with mean age of 44.63 and mean BMI of 25.69) underwent both full PSG and Watch-PAT were analyzed. Watch-PAT demonstrates good reliability with approximately 100% sensitivity to detect patients with OSA. In comparing the data of Watch-PAT with PSG, the mean overestimation of Apnea Hypopnea Index (AHI) and Respiratory Disturbance Index (RDI) by Watch-PAT are 2.59 and 4.07 respectively (p< 0.01). The accurate prediction of OSA severity is found to be around 68%, whereas overestimation and underestimation are 30% and 2% respectively in comparison with the gold standard PSG. High correlation exists between PSG and watch-PAT for AHI (r = 0.957, p < 0.01) & RDI (r = 0.950, p < 0.01). As Watch-Pat can be undergone at home without occupancy of inpatient bed, it not merely sorts out a long waiting time for overnight PSG at hospital with the selected cases; but also can reserve more inpatient bed for other patients with acute illness so as to attain a win-win strategy.

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