OXIMETRY-BASED DEVICES IN DIAGNOSIS OF OBSTRUCTIVE SLEEP APNEA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Introduction: Obstructive sleep apnea (OSA) is a common disorder, associated with significant morbidity and mortality. Polysomnography (PSG) or a home sleep apnea test (HSAT) is required for OSA diagnosis. Recently, several oximetry-based devices have been developed to assist with diagnosing OSA. Objectives: This study aims to evaluate the diagnostic performance of these oximetry-based devices compared to PSG. Methods: We performed research in MEDLINE, EMBASE, Google Scholar, and Lilacs databases. We included studies that evaluated oximetry-based devices in comparison to PSG for OSA diagnosis in adults. Selected studies were divided into two subgroups: consumer wearable devices and medical devices. Results: A total of 18 studies were included in the analysis, with 4 studies in consumer wearable devices subgroup and 14 studies in medical devices subgroup). The overall sensitivity was 97% (95% Confidence Interval [CI]: 96 – 97%) and specificity was 63% (95% CI: 61 – 65) of oximetry-based devices for OSA diagnosis. In the consumer wearable devices subgroup, sensitivity was 93% (95% CI: 90 – 96) and specificity was 63% (95% CI: 53 – 71). In the medical devices subgroup, sensitivity was also high as 97% (95% CI: 96 – 97) with a specificity of 63% (95% CI: 61 – 65). The summary area under the curve was 0.90 and the estimated post-test probability was 90%. Conclusions: Oximetry-based devices have high sensitivity and high post-test probability but low specificity in adults at high risk for OSA diagnosis. Further research is necessary to assess these devices, particularly wearable ones, especially in low-risk individuals and those with comorbidities.