To evaluate the effectiveness of overnight pulse oximetry combined with AI for diagnosing obstructive sleep apnea (OSA).
Approach:
AI and Pulse Oximetry: Advancements in AI allow for the use of pulse oximetry readings as a viable input for diagnosing OSA, particularly in settings where polysomnography is not feasible [Andrés-Blanco AM, Álvarez D, Crespo A, et al. Assessment of automated analysis of portable oximetry as a screening test for moderate-to-severe sleep apnea in patients with chronic obstructive pulmonary disease. PLoS One. 2017;12(11):e0188094. [CrossRef] [Medline]12-Levy J, Álvarez D, Del Campo F, Behar JA. Deep learning for obstructive sleep apnea diagnosis based on single channel oximetry. Nat Commun. Aug 12, 2023;14(1):4881. [CrossRef] [Medline]14].
Key Findings:
Pulse oximetry is a simple, noninvasive tool relevant for OSA diagnosis due to its ability to detect drops in arterial oxygen saturation [Álvarez D, Gutiérrez-Tobal GC, Vaquerizo-Villar F, Moreno F, Del Campo F, Hornero R. Oximetry indices in the management of sleep apnea: from overnight minimum saturation to the novel hypoxemia measures. Adv Exp Med Biol. 2022;1384:219-239. [CrossRef] [Medline]15].
Oxygen desaturation index (ODI) derived from SpO2 correlates with apnea-hypopnea index (AHI) but has modest specificity [Wang Y, Fietze I, Salanitro M, Penzel T. Comparison of the value of the STOP-BANG questionnaire with oxygen desaturation index in screening obstructive sleep apnea in Germany. Sleep Breath. Aug 2023;27(4):1315-1323. [CrossRef] [Medline]16].
AI-driven analysis of SpO2 data may enhance diagnostic accuracy by overcoming limitations of traditional oximetry [Levy J, Álvarez D, Del Campo F, Behar JA. Deep learning for obstructive sleep apnea diagnosis based on single channel oximetry. Nat Commun. Aug 12, 2023;14(1):4881. [CrossRef] [Medline]14].
Interpretation:
While pulse oximetry shows promise for OSA diagnosis, its standalone use is limited by the inability to differentiate between central and obstructive events and to identify sleep stages [Koh JH, Lim CYJ, Yam KJM, et al. Bidirectional association of sleep disorders with chronic kidney disease: a systematic review and meta-analysis. Clin Kidney J. Nov 2024;17(11):sfae279. [CrossRef] [Medline]2-Tan BKJ, Tan NKW, Teo YH, et al. Association of obstructive sleep apnea with thyroid cancer incidence: a systematic review and meta-analysis. Eur Arch Oto Rhino Laryngol. Nov 2022;279(11):5407-5414. [CrossRef] [Medline]6].
Limitations:
Oximetry cannot differentiate between central and obstructive sleep apnea [Koh JH, Lim CYJ, Yam KJM, et al. Bidirectional association of sleep disorders with chronic kidney disease: a systematic review and meta-analysis. Clin Kidney J. Nov 2024;17(11):sfae279. [CrossRef] [Medline]2-Tan BKJ, Tan NKW, Teo YH, et al. Association of obstructive sleep apnea with thyroid cancer incidence: a systematic review and meta-analysis. Eur Arch Oto Rhino Laryngol. Nov 2022;279(11):5407-5414. [CrossRef] [Medline]6].
It does not provide information on sleep stages [Goyal M, Johnson J. Obstructive sleep apnea diagnosis and management. Mo Med. 2017;114(2):120-124. [Medline]8].
Conclusion:
AI-enhanced analysis of pulse oximetry data may improve OSA diagnosis, addressing the limitations of current diagnostic methods [Levy J, Álvarez D, Del Campo F, Behar JA. Deep learning for obstructive sleep apnea diagnosis based on single channel oximetry. Nat Commun. Aug 12, 2023;14(1):4881. [CrossRef] [Medline]14].
by Kvan Jie Ming Yam, Claire Yi Jia Lim, Esther Yanxin Gao, Jin Hean Koh, Nicole Kye Wen Tan, Adele Chin Wei Ng, Zhou Hao Leong, Chu Qin Phua, Thun How Ong, Leong Chai Leow, Guang-Bin Huang, Benjamin Kye Jyn Tan, Song Tar Toh
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