This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Diagnosis of obstructive sleep apnea/hypopnea syndrome (OSAHS) is usually made from a full night polysomnography performed in the sleep laboratory with complete monitoring of sleep, O2 saturation and respiration. This process is both time consuming and expensive. In addition, increasing numbers of patients referred to sleep centers, particularly for symptoms of obstructive sleep apnea syndrome, produce delays of up to 1 year in some centers in the performance of this study. As a result, the development of a simplified accurate method of diagnosing OSAHS is highly desirable. The Apnea Risk Evaluation System (ARES) uses a multivariate approach that integrates: a self-applied, single site device to continuously record a) forehead pulse oximetry and pulse rate; b) nasal airflow and snoring; and c) head movements and position; combined with a validated questionnaire based on anthropomorphic and clinical information. Automated software applies a novel scoring algorithm to these signals to recognize and quantify abnormal respiratory events. This system has been shown to have a good sensitivity and specificity for diagnosis of OSAHS. The investigators have previously shown that the use of a nasal cannula/pressure transducer system for monitoring nasal flow has provided a reliable and easy-to-use measure of sleep disordered breathing (SDB) events and that monitoring of a nasal airflow could provide sufficient information to make an accurate diagnosis of OSAHS. Prior validation studies of the ARES system did not make use of the nasal airflow signal in the scoring algorithm. The present study proposes to incorporate the nasal cannula airflow signal into the ARES system. The sensitivity and specificity of this system for diagnosis of OSAHS will be evaluated comparing the ARES portable system with a full in-laboratory polysomnography. If a high degree of diagnostic accuracy can be demonstrated, the ARES system would provide an unattended, low-cost alternative diagnostic strategy for patients with OSAHS.
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