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Original Research |

Comparison of the Indices of Oxyhemoglobin Saturation by Pulse Oximetry in Obstructive Sleep Apnea Hypopnea Syndrome

Chen-Liang Lin, PhD; Chinson Yeh, PhD; Chen-Wen Yen, PhD; Wu-Huei Hsu, MD, FCCP; Liang-Wen Hang, MD*
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*From the Department of Mechanical and Electro-Mechanical Engineering (Drs. Lin, Yeh, and Yen), National Sun Yat-Sen University, Kaohsiung; and Sleep Medicine Center (Dr. Hang), Department of Internal Medicine, and Division of Pulmonary and Critical Care (Dr. Hsu), Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.

Correspondence to: Liang-Wen Hang, MD, Sleep Medicine Center, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Rd, North District, Taichung City 404, Taiwan; e-mail: lungwen.hang@gmail.com

*Data are presented as mean ± SD or No. NS = not significant.

†Between the learning and validation sets.

*Definition of terms: A = mean of all-night oxygen; 3M = mean of first 3 min of overnight oxygen recording; 1M20 = mean of top 20% of oxyhemoglobin values over the 1 min preceding the scanned oxyhemoglobin.

†Correlation and p value were between indices and AHI.

*CT90 = cumulative time spent below 90%; CT80 = cumulative time spent below 80%; DI90 = threshold and fall index in Spo2 to ≤ 90%. See Figure 1 legend for expansion of abbreviations.

†Correlations and p values were between indices and AHI.

*Data are presented as mean (95% confidence interval).

*Data are presented as mean (95% confidence interval).

The study was approved by the Medical Research Ethics Committee of the China Medical University Hospital. The study number is DMR 96-IRB-17.

This study was supported by a grant from China Medical University Hospital (DMR-97-029).

The authors have no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


The study was approved by the Medical Research Ethics Committee of the China Medical University Hospital. The study number is DMR 96-IRB-17.

The study was approved by the Medical Research Ethics Committee of the China Medical University Hospital. The study number is DMR 96-IRB-17.

This study was supported by a grant from China Medical University Hospital (DMR-97-029).

This study was supported by a grant from China Medical University Hospital (DMR-97-029).

The authors have no conflicts of interest to disclose.

The authors have no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(1):86-93. doi:10.1378/chest.08-0057
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Objectives:  To comprehensively evaluate the ability and reliability of the representative previously proposed oxyhemoglobin indexes derived automatically for predicting the severity of obstructive sleep apnea hypopnea syndrome (OSAHS).

Methods:  Patients with a diagnosis of OSAHS by standard polysomnography were recruited from China Medical University Hospital Centre. There were 257 patients in the learning set and 279 patients in the validation set. The presence of OSAHS was defined as apnea-hypopnea index (AHI) > 5/h. Three kinds of oxyhemoglobin indexes, including the oxyhemoglobin desaturation index (ODI), time-domain index, and frequency-domain index, were used. Degrees of severity were AHI > 15/h and AHI > 30/h, representing moderate and severe OSAHS. A total of 28 oxyhemoglobin indexes were tested in our study.

Results:  Among the three kinds of indexes, ODI had a better diagnostic performance than the time-domain and frequency-domain indexes, with the results coincident in the validation set and learning set. For predicting the severity of OSAHS with AHI > 15/h or > 30/h, the ODI clinically had the higher correlation with AHI than time-domain and frequency-domain indexes, with sensitivity/specificity achieving 84.0%/84.3% in AHI > 15/h and 87.8%/96.6% in AHI > 30/h, respectively.

Conclusions:  Based on the smaller SEE of the AHI, the ODI had a significantly smaller SEE than the time-domain and frequency-domain indexes. The ODI index provided a high level of diagnostic sensitivity and specificity at different degrees of OSAHS severity.

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