Feasibility of at-home continuous overnight pulse oximetry for obstructive sleep apnea screening in bariatric surgery candidates

Abstract

Purpose

Screening for obstructive sleep apnea (OSA) is recommended in patients scheduled for bariatric surgery because continuous positive airway pressure (CPAP) therapy in patients with moderate-to-severe OSA reduces postoperative complications. However, cardiorespiratory polygraphy (CRP) and polysomnography (PSG) are expensive and time-consuming. The present study aimed to assess whether at-home continuous overnight pulse oximetry can be used to diagnose moderate-to-severe OSA in patients scheduled for bariatric surgery.

Methods

In this prospective observational study, we enrolled consecutive patients scheduled for bariatric surgery. Patients with no prior OSA diagnosis were evaluated using the ESS, SBQ, and preoperative at-home CRP. Correlations were calculated between AHI and oximetry parameters. For each oximetry parameter, a receiver-operating characteristic (ROC) curve was generated to identify optimal cut-off values for diagnosing moderate-to-severe OSA.

Results

In total, 117 patients were included. The oxygen desaturation index was the most correlated oximetry parameter; the optimal cut-off value for diagnosing moderate-to-severe OSA was 23.9. The sensitivity and specificity were 80 and 92%, respectively. The area under the ROC curve was 0.935.

Conclusions

At-home continuous overnight pulse oximetry could be used to screen moderate-to-severe OSA in patients scheduled for bariatric surgery because it would allow clinicians to implement early CPAP therapy and avoid preoperative PSG or CRP.

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Funding

No funding was received for conducting this study.

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Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by SN-M, MC-L and SM-Q. The first draft of the manuscript was written by SN-M and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sergio Navarro-Martínez.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Doctor Peset University Hospital Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study. No individual. There are no photographs or information that could be used to identify individual participants in the study.

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Navarro-Martínez, S., Carrasco-Llatas, M., Matarredona-Quiles, S. et al. Feasibility of at-home continuous overnight pulse oximetry for obstructive sleep apnea screening in bariatric surgery candidates. Eur Arch Otorhinolaryngol (2021). https://doi.org/10.1007/s00405-021-06660-5

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Keywords

  • Bariatric surgery
  • Obstructive sleep apnea
  • Screening
  • Questionnaires
  • Oximetry