Obstructive sleep apnea (OSA) is a disease characterized by a brief period of cessation or marked decline in ventilation. The standard treatment is continuous positive airway pressure (CPAP). To determine the indication, full-night polysomnography (PSG) is required; however, it is a stressful examination. We verified the usefulness of pulse-oximetry at home as a predictor for CPAP indication before PSG. Simultaneously, the clinical background and cephalometry were also verified. Among 376 subjects who received PSG at our hospital from February 2005 to April 2020, 138 subjects received pulse-oximetry at home before PSG were enrolled retrospectively and performed logistic regression analysis on those with CPAP indication. Concurrently, 262 of 376 subjects received cephalometry were enrolled, and logistic regression analysis were performed using clinical background and cephalometry. A 3% oxygen desaturation (3% ODI) on the pulse-oximeter was a predictor for CPAP indication. The positive predictive value of 3% ODI ≥ 28.5 events/h was 73.3% and the negative predictive value was 62.5%. Older age, higher body mass index (BMI), stronger lower jaw retraction (wider ∠ANB), and longer distance from the anterior superior tip of the hyoid bone to the mandibular plane (MP-H) on cephalometry were also independent predictors. The positive predictive value when both BMI ≥ 26.0 kg/m 2 and MP-H ≥ 17.5 mm were present was 88.2% and the negative predictive value when both were absent was 71.3%. The combination of clinical background and cephalometry would be a useful screening tool as well as a pulse-oximetry at home for CPAP indication.

中文翻译：

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日本有CPAP指征的阻塞性睡眠呼吸暂停的临床背景和头影测量的风险评估

阻塞性睡眠呼吸暂停 (OSA) 是一种以短暂停止呼吸或通气显着下降为特征的疾病。标准治疗是持续气道正压通气 (CPAP)。为了确定适应症，需要整夜多导睡眠图 (PSG)；然而，这是一个压力很大的考试。我们验证了在家中脉搏血氧饱和度测量作为 PSG 前 CPAP 指征的预测指标的有用性。同时，还验证了临床背景和头影测量法。2005年2月至2020年4月在我院接受PSG治疗的376名受试者中，138名受试者在PSG前在家中接受脉搏血氧测定，回顾性入组CPAP指征者进行logistic回归分析。同时，376 名接受头颅测量的受试者中有 262 名被招募，使用临床背景和头影测量法进行逻辑回归分析。脉搏血氧仪上 3% 的氧饱和度下降 (3% ODI) 是 CPAP 指征的预测指标。3% ODI ≥ 28.5 个事件/小时的阳性预测值为 73.3%，阴性预测值为 62.5%。年龄较大、体重指数 (BMI) 较高、下颌后缩力更强（∠ANB 更宽）以及头颅测量法上从舌骨前上尖到下颌平面 (MP-H) 的距离更长也是独立的预测因素。当 BMI ≥ 26.0 kg/m 2 和 MP-H ≥ 17.5 mm 存在时，阳性预测值为 88.2%，两者都不存在时的阴性预测值为 71.3%。临床背景和头颅测量法的结合将是一种有用的筛查工具以及在家中用于 CPAP 指征的脉搏血氧饱和度测量法。