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Digital oximetry-based monitoring during sleep as a follow-up tool in OSA patients.
Polysomnography (PSG) is mandatory for diagnose and follow-up of Obstructive sleep Apnea (OSA) patients treated with Positive Airway Pressure (PAP) or Oral Appliance (OA); however, this so-called gold standard is expensive, time-consuming and of difficult access. Additionally, there are patients refusing a second sleep lab study after clinical control. In Dental Sleep Medicine (DSM) practices this situation is common and becomes a significant issue because of the need of a tighter control due to the absence of devices supporting follow-up measures. The Sleep Apnea Digital Monitoring (SADM), a home-styled oximetry that provides diagnostic performance in detecting severe OSA was recently proposed as a good option pursuing adequate follow-up and treatment success. The BIOLOGIX, a high resolution DSAM and accurate OXISTAR® sensor can be used to monitor patients and can be a good tool for DSM professional, particularly regarding those patients refusing a second sleep lab study to confirm the efficacy OAT.
The main purpose of this study was to test DSAM in the follow-up of OSA patients clinically controlled with OAT and evaluated the coherence between the correlated data used by different methods.
OA adherent 15 male and 7 female patients (n=22) with BMI of 26,67 +/- 3.61 and AHI of 14.22 +/- 18.75 ev/h in PSG baseline and ESS 8.29 +/- 4.06 where retrospectively assessed. Patients used DIORS® OA and BIOLOGIX all night available from April to September 2019. Oxygen Saturation (SaO2) and heart rate (HR), common parameters, were compared. The study was adjusted with Excel software support and a significance level of 5% was adopted for the results interpretation .
The data show improvement in minimum SaO2 go the 84.76 +/- 5.20 to 88.43 +/- 3.23; p=0,0168, mean HR 52.22 +/- 7.55 to 50.95 +/- 5.74; p=0,0031 and ESS the 8.29 +/- 4.06 to 6,38 +/- 2.73; p=0,0003.
A linear relationship show correlation in Mean HB and ESS measurements kept in two phases and a small correlation in SAO2 was observed considering the coefficient evaluation. Other values kept no relation, which cannot be conclusive in clinical conditions. Therefore, some data confirm DSAM as a follow-up for OAT, but nonsignificant variables require further studies, using measurements association and evaluating co-relationship by both methods at the same time.
diagnosis; pulse oximetry; treatment; activator appliances; upper airway resistance syndrome; clinical assessment
ESALQ - USP - São Paulo - Brasil, FOP - UNICAMP - - Brasil
Denise Fernandes Barbosa, Miguel Gonçalves Meira e Cruz, Marcelo Corrêa Alves, Fausto Berzin