Abstract

META-ANALYSIS: PERIPHERAL ARTERIAL TONOMETRY FOR DIAGNOSIS OF OBSTRUCTIVE SLEEP APNEA

Hussam Salem Aljohani*, Maha Thiab Alshbiny, Nawaf Abdalwahab Almndil, Ayman Abdullah Alamri, Yasser Adnan Alowaidi, Abdullah Fahad Alzamil, Omar Oudah A. Aljohani, Abdullah Mansour Alharthi, Abdulrhman Abdulaziz Alshehri, Tariq Hadyan Alruwaili, Omar Suliman Alluhaydan, Ahmad Ayesh Alshehri, Sukainah Saleh Alismail

Abstract

Background & Purpose: The usage of a finger bound polysomnography, peripheral arterial tonometry (PAT) measures the peripheral arterial tone. The peripheral arterial tone is dictated by means of peripheral blood pressure, sympathetic activity, and through the peripheral resistance of the vessels. WatchPAT system uses the above principle alongside other body parameters (pulse oximetry, coronary heart rate, and actigraphy) in an set of rules to determine apnea/hypopnea index (AHI) and breathing disturbance index (RDI). The Aim of this work is to provide cumulative data about the efficacy of Peripheral Arterial Tonometry (PAT) for diagnosis of Obstructive Sleep Apnea (OSA), as compared to polysomnography (PSG). Methods: A systematic search was performed of PubMed, Cochrane library Ovid, Scopus & Google scholar to identify ENT RCTs, clinical trials, and comparative studies, which studied the correlation of sleep indexes, specifically the Respiratory Disturbance Index (RDI) and Apnea-Hypopnea Index (AHI) as measured by PAT and PSG. A meta-analysis was done using fixed and random-effect methods. The primary outcome was correlation between AHI in both devices (PAT/PSG). Secondary outcome was correlation between RDI in both devices (PAT/PSG). Results: A total of 6 studies were identified involving 409 patients. Regarding primary outcome measures, the random-effects model of the meta-analysis study showed highly significant increase in AHI correlation coefficient between PAT and PSG (p < 0.01). Regarding secondary outcome measure, the random-effects model of the meta- analysis study showed highly significant increase (strong) RDI correlation coefficient between PAT and PSG (p< 0.01). Conclusion: To conclude, PAT and PSG values were highly correlated. This finding demonstrated that the reproducibility of the results obtained with PAT was also high. This study shows that PAT can be used as a screening test for OSAS and in a group of patients who are highly suspected for OSAS.

Keywords: Peripheral arterial tonometry, obstructive sleep apnea, polysomnography.