Accuracy of ECG-based screening for sleep-disordered breathing: a survey of all male workers in a transport companyReportar como inadecuado

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Sleep and Breathing

, Volume 17, Issue 1, pp 243–251

First Online: 20 March 2012Received: 06 January 2012Revised: 08 February 2012Accepted: 05 March 2012


PurposeSleep-disordered breathing SDB is associated with increased risk for cardiovascular morbidity and mortality and for sleepiness-related accidents, but >75 % of the patients remain undiagnosed. We sought to determine the diagnostic accuracy of ECG-based detection of SDB when used for population-based screening.

MethodsAll male workers, mostly truck drivers, of a transport company n = 165; age, 43 ± 12 years underwent standard attended overnight polysomnography. Cyclic variation of heart rate CVHR, a characteristic pattern of heart rate associated with SDB, was detected from single-lead ECG signals during the polysomnography by a newly developed automated algorithm of autocorrelated wave detection with adaptive threshold ACAT.

ResultsAmong 165 subjects, the apnea–hypopnea index AHI was ≥5 in 62 38 %, ≥15 in 26 16 %, and ≥30 in 16 10 %. The number of CVHR per hour CVHR index closely correlated with AHI r = 0.868 95 % CI, 0.825–0.901. The areas under the receiver operating characteristic curves for detecting subjects with AHI ≥5, ≥15, and ≥30 were 0.796 95 % CI, 0.727–0.855, 0.974 0.937–0.993, and 0.997 0.971–0.999, respectively. With a predetermined criterion of CVHR index ≥15, subjects with AHI ≥15 were identified with 88 % sensitivity and 97 % specificity likelihood ratios for positive and negative test, 30.7 and 0.12. The classification performance was retained in subgroups of subjects with obesity, hypertension, diabetes mellitus, dyslipidemia, and decreased autonomic function.

ConclusionsThe CVHR obtained by the ACAT algorithm may provide a useful marker for screening for moderate-to-severe SDB among apparently healthy male workers.

KeywordsApnea–hypopnea index Cyclic variation of heart rate Electrocardiogram Sleep apnea Sleep-disordered breathing Population  Download fulltext PDF

Autor: Junichiro Hayano - Teruomi Tsukahara - Eiichi Watanabe - Fumihiko Sasaki - Kiyohiro Kawai - Hiroki Sakakibara - Itsuo Kodam


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