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New diagnostic tools to screen and assess a still too underestimated disease: the role of the wrist-worn peripheral arterial tonometry device—a systematic review

  • Sleep Breathing Physiology and Disorders • Review
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Abstract

Purpose

Home sleep apnea testing devices aim to overcome the drawbacks of polysomnography (PSG). Among these, the WatchPAT (WP) (Itamar Medical Ltd., Caesarea, Israel) has recently been introduced on the market for diagnosis of Obstructive Sleep Apnea (OSA). The aim of this review was to provide a comprehensive overview of the studies validating the WP for the diagnosis of sleep-disordered breathing through comparison with PSG.

Methods

A systematic review was performed to identify all clinical studies concerning WP validation compared with PSG as diagnostic tools. A qualitative analysis of the data was conducted.

Results

In this review, 18 studies were included for a total of 1049 patients, aged 8 to 70 years old, with 74 of these being pediatric patients. In most studies, patients completed an overnight PSG and simultaneously wore WatchPAT in a sleep laboratory, while others compared the results obtained on two different nights. Both protocols showed good results in terms of AHI, ODI, RDI, and SO2. Moreover, some studies calculated the sensitivity and specificity of the WP ranging from 87 to 96% and from 66 to 80%, respectively. Excellent results were found also in pediatric patients.

Conclusion

The WP represents an effective and convenient tool for OSA diagnosis compared to standard reference systems.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Baptista PM et al (2021) Daytime neuromuscular electrical therapy of tongue muscles in improving snoring in individuals with primary snoring and mild obstructive sleep apnea. J Clin Med 10(9):1883. https://doi.org/10.3390/JCM10091883

    Article  PubMed  PubMed Central  Google Scholar 

  2. Armeni P, Borsoi L, Costa F, Donin G, Gupta A (2019) Final report cost-of-illness study of Obstructive Sleep Apnea Syndrome (OSAS) in Italy

  3. Passali D, Caruso G, Arigliano LC, Passali FM, Bellussi L (2012) Database application for patients with obstructive sleep apnoea syndrome. Acta Otorhinolaryngol Ital 32(4):252–255

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Gottlieb DJ, Punjabi NM (2020) Diagnosis and management of obstructive sleep apnea: a review. JAMA - J Am Med Assoc 323(14):1380–1400. https://doi.org/10.1001/jama.2020.3514

    Article  Google Scholar 

  5. Kushida CA et al (2005) Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 28(4):499–521. https://doi.org/10.1093/SLEEP/28.4.499

    Article  PubMed  Google Scholar 

  6. Choi JH et al (2010) Validation study of portable device for the diagnosis of obstructive sleep apnea according to the new AASM scoring criteria: Watch-PAT 100. Acta Otolaryngol 130(7):838–843. https://doi.org/10.3109/00016480903431139

    Article  PubMed  Google Scholar 

  7. Ayas NT, Pittman S, MacDonald M, White DP (2003) Assessment of a wrist-worn device in the detection of obstructive sleep apnea. Sleep Med 4(5):435–442. https://doi.org/10.1016/S1389-9457(03)00111-4

    Article  PubMed  Google Scholar 

  8. Choi JH, Lee B, Lee JY, Kim HJ (2018) Validating the Watch-PAT for diagnosing obstructive sleep apnea in adolescents. J Clin Sleep Med 14(10):1741–1747. https://doi.org/10.5664/jcsm.7386

    Article  PubMed  PubMed Central  Google Scholar 

  9. “Regulations and guidance | CMS.” https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance (accessed Mar. 22, 2022).

  10. Paruthi S et al (2016) Consensus statement of the American Academy of Sleep Medicine on the recommended amount of sleep for healthy children: methodology and discussion. J Clin Sleep Med 12(11):1549–1561. https://doi.org/10.5664/JCSM.6288

    Article  PubMed  PubMed Central  Google Scholar 

  11. Di Pumpo M et al (2021) Multiple-access versus telemedicine home-based sleep apnea testing for obstructive sleep apnea (OSA) diagnosis: a cost-minimization study. Sleep Breath 1:1. https://doi.org/10.1007/S11325-021-02527-5

    Article  Google Scholar 

  12. Bar A, Pillar G, Dvir I, Sheffy J, Schnall RP, Lavie P (2003) Evaluation of a portable device based on peripheral arterial tone for unattended home sleep studies. Chest 123(3):695–703. https://doi.org/10.1378/chest.123.3.695

    Article  PubMed  Google Scholar 

  13. Ceylan T, Firat H, Kuran G, Ardiç S, Bilgin E, Çelenk F (2012) Quick diagnosis in obstructive sleep apnea syndrome: WatchPAT-200. Iran Red Crescent Med J 14(8):4

    Google Scholar 

  14. O’Brien LM, Bullough AS, Shelgikar AV, Chames MC, Armitage R, Chervin RD (2012) Validation of watch-PAT-200 against polysomnography during pregnancy. J Clin Sleep Med 8(3):287–294. https://doi.org/10.5664/jcsm.1916

    Article  PubMed  PubMed Central  Google Scholar 

  15. Tauman R et al (2020) Watch-PAT is useful in the diagnosis of sleep apnea in patients with atrial fibrillation</p>. Nat Sci Sleep 12:1115–1121. https://doi.org/10.2147/NSS.S278752

    Article  PubMed  PubMed Central  Google Scholar 

  16. Moher D et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Plos Med 6 (7). https://doi.org/10.1371/journal.pmed.1000097

  17. Onder NS, Akpinar ME, Yigit O, Gor AP (2012) Watch peripheral arterial tonometry in the diagnosis of obstructive sleep apnea: influence of aging. Laryngoscope 122(6):1409–1414. https://doi.org/10.1002/lary.23233

    Article  PubMed  Google Scholar 

  18. Pang KP, Gourin CG, Terris DJ (2007) A comparison of polysomnography and the WatchPAT in the diagnosis of obstructive sleep apnea. Otolaryngol - Head Neck Surg 137(4):665–668. https://doi.org/10.1016/j.otohns.2007.03.015

    Article  PubMed  Google Scholar 

  19. Penzel T, Kesper K, Pinnow I, Becker HF, Vogelmeier C (2004) Peripheral arterial tonometry, oximetry and actigraphy for ambulatory recording of sleep apnea. Physiol Meas 25(4):1025–1036. https://doi.org/10.1088/0967-3334/25/4/019

    Article  PubMed  Google Scholar 

  20. Weimin L, Rongguang W, Dongyan H, Xiaoli L, Wei J, Shiming Y (2013) Assessment of a portable monitoring device WatchPAT 200 in the diagnosis of obstructive sleep apnea. Eur Arch Otorhinolaryngol 270(12):3099–3105. https://doi.org/10.1007/s00405-013-2555-4

    Article  PubMed  Google Scholar 

  21. Körkuyu E et al (2015) The efficacy of Watch PAT in obstructive sleep apnea syndrome diagnosis. Eur Arch Otorhinolaryngol 272(1):111–116. https://doi.org/10.1007/s00405-014-3097-0

    Article  PubMed  Google Scholar 

  22. Pillar G, Bar A, Shlitner A, Schnall R, Shefy J, Lavie P (2002) Autonomic arousal index: an automated detection based on peripheral arterial tonometry. Sleep 25(5):543–549. https://doi.org/10.1093/sleep/25.5.541

    Article  PubMed  Google Scholar 

  23. Hedner J et al (2011) Sleep staging based on autonomic signals: a multi-center validation study. J Clin Sleep Med 7(3):301–306. https://doi.org/10.5664/JCSM.1078

    Article  PubMed  PubMed Central  Google Scholar 

  24. Boyd SB et al (2016) Effective apnea-hypopnea index (‘effective ahi’): a new measure of effectiveness for positive airway pressure therapy. Sleep 39(11):1961–1972. https://doi.org/10.5665/sleep.6224

    Article  PubMed  PubMed Central  Google Scholar 

  25. Zou D, Grote L, Peker Y, Lindblad U, Hedner J (2006) Validation a portable monitoring device for sleep apnea diagnosis in a population based cohort using synchronized home polysomnography. Sleep 29(3):367–374. https://doi.org/10.1093/sleep/29.3.367

    Article  PubMed  Google Scholar 

  26. Yuceege M, Firat H, Demir A, Ardic S (2013) Reliability of the Watch-PAT 200 in detecting sleep apnea in highway bus drivers. J Clin Sleep Med 9(4):339–344. https://doi.org/10.5664/jcsm.2584

    Article  PubMed  PubMed Central  Google Scholar 

  27. Pittman SD, Ayas NT, MacDonald MM, Malhotra A, Fogel RB, White DP (2004) Using a wrist-worn device based on peripheral arterial tonometry to diagnose obstructive sleep apnea: in-laboratory and ambulatory validation. Sleep 27(5):923–933. https://doi.org/10.1093/sleep/27.5.923

    Article  PubMed  Google Scholar 

  28. Tanphaichitr A, Thianboonsong A, Banhiran W, Vathanophas V, Ungkanont K (2018) Watch peripheral arterial tonometry in the diagnosis of pediatric obstructive sleep apnea. Otolaryngol Head Neck Surg (United States) 159(1):166–172. https://doi.org/10.1177/0194599818768215

    Article  Google Scholar 

  29. Kapur VK et al (2017) Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med 13(3):479. https://doi.org/10.5664/JCSM.6506

    Article  PubMed  PubMed Central  Google Scholar 

  30. Casale M et al (2022) No-cutting remodelling intra-pharyngeal surgery can avoid CPAP in selected OSA patients: myth or reality? Eur Arch Otorhinolaryngol (0123456789). https://doi.org/10.1007/s00405-022-07261-6

  31. Yalamanchali S, Farajian V, Hamilton C, Pott TR, Samuelson CG, Friedman M (2013) Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: meta-analysis. JAMA Otolaryngol Head Neck Surg 139(12):1343–1350. https://doi.org/10.1001/JAMAOTO.2013.5338

    Article  PubMed  Google Scholar 

  32. Iftikhar IH, Finch CE, Shah AS, Augunstein CA, Ioachimescu OC (2022) A meta-analysis of diagnostic test performance of peripheral arterial tonometry studies. J Clin Sleep Med 18(4):1093–1102. https://doi.org/10.5664/JCSM.9808

    Article  PubMed  PubMed Central  Google Scholar 

  33. Pillar G et al (2020) Detecting central sleep apnea in adult patients using WatchPAT—a multicenter validation study. Sleep Breath 24(1):387. https://doi.org/10.1007/S11325-019-01904-5

    Article  PubMed  Google Scholar 

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Correspondence to Antonio Moffa.

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Moffa, A., Giorgi, L., Carnuccio, L. et al. New diagnostic tools to screen and assess a still too underestimated disease: the role of the wrist-worn peripheral arterial tonometry device—a systematic review. Sleep Breath 27, 817–828 (2023). https://doi.org/10.1007/s11325-022-02700-4

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