Update on the use of portable monitoring system for the diagnosis of sleep apnea in specific population

Table 1 Sleep evaluation studies for the diagnosis of sleep disordered breathing

	Type 1 full attended polysomnography	Type 2 full unattended polysomnography	Type 3 limited channels devices	Type 4 continuous single or dual bioparameter recording
Number of channels	Minimum 7	Minimum 7	Minimum 4	Minimum of 1
Parameters	EEG, EOG, chin EMG, ECG, airflow, respiratory effort, oxygen saturation	EEG, EOG, chin EMG, ECG, airflow, respiratory effort, oxygen saturation	Ventilation (at least two channels of respiratory movement or respiratory movement and airflow), heart rate or ECG, oxygen saturation	Usually oxygen saturation and/or airflow
Body position	Documented or objectively measured	May be objectively measured	May be objectively measured	Not measured
Leg movement	EMG or motion sensor desirable	EMG or motion sensor desirable	May be recorded	Not recorded
Personnel	In constant attendance	Not in attendance	Not in attendance	Not in attendance

Adapted from Ferber et al[8]. EEG: Electroencephalogram; EOC: Electrooculogram; EMG: Electromyogram; ECG: Electrocardiogram.

Table 2 Scoper categorization

Sleep	Cardiovascular	Oximetry	Position	Effort	Respiratory
S1-3 EEG channels1 + EOG + chin EMG	C1-More than 1 ECG lead	O1-Oximetry (ear or finger) with recommended sampling2	P1-Video or visual position measurement	E1-Two RIP belts	R1-Nasal pressure and thermal device
S2-Less than 3 EEG channels with/without EOG or chin EMG	C2-Peripheral arterial tonometry	O1x-Oximetry (ear or finger) without recommended sampling	P2-Nonvisual position measurement	E2-One RIP belt	R2-Nasal pressure
S3-Sleep surrogate: e.g., actigraphy	C3-Standard ECG measure (one lead)	O2-Oximetry with alternative site		E3-Derived effort	R3-Thermal device
S4-Other sleep measure	C4-Derived pulse	O3-Other oximetry		E4-Other effort measures	R4-End-tidal CO2
	C5-other cardiac measures				R5-Other respiratory measures

¹Frontal, central and occipital;

²3 s averaging and a minimum of 10 Hz sampling rate. Adapted from Collop et al[9]. EEG: Electroencephalogram; EOC: Electrooculogram; EMG: Electromyogram; RIP: Respiratory inductance plethysmography.

Table 3 Summary of manuscripts of the use of portable monitoring in specific population

Ref.	Year	Population	Sample size	Device	Protocol
Morales et al[24]	2012	Elderly mean age 71.4 yr	452	Rescare AutosetTM (ResMed, Sydney, Australia)	PM at home PSG at sleep lab
Polese et al[22]	2013	Elderly > 65 yr	43	Stardust II® (Phillips Respironics, Inc., Murrysville, PA, United States)	PM home PM + PSG at sleep lab
Goodwin et al[31]	2001	Children 5 to 12 yr	157	Compumedics PS-2 System (Abbotsford, Victoria, Australia)	PM at home
Zucconi et al[32]	2003	Children 3 to 6 yr	12	POLY-MESAM; MAP; Martinsried, Germany	PSG at sleep lab PM at sleep lab
Poels et al[30]	2003	Children 2 to 7 yr	24	Embletta PDS; Flaga hf Medical Devices, Reykjavik, Iceland)	PM at home
Rosen et al[35]	2003	Children 8 to 11 yr	55	PT-2 System SensorMedics, Yorba Linda, California, United States	PM home PSG lab
Alvarez et al[34]	2008	Children 2 to 14 yr	53	Edentec Monitoring System (Edentrace II, Model 3711; Edentec Corporation, Nellcor Puritan Bennett, Eden Prairie, Minnesota, United States)	PSG + PM at sleep lab
Sardón Prado et al[37] (abstract)	2006	Children	132	Not informed	PM at hospital PM at home
Amorim et al[38] (abstract)	2004	Children Mean age 10.6 yr	31	Not informed	PM at home
Quintana-Gallego et al[50]	2004	Heart failure LVEF ≤ 45%	75	Apnoescreen II; Erich Jaeger Gmbh and CoKg, Wuerzburg, Germany	PSG at sleep lab PM at home
Abraham et al[51]	2006	Heart failure LVEF ≤ 35%	50	ClearPath System Nx-301; Nexan Inc, Alpharetta, GA	PSG + PM at sleep lab PM at home
Smith et al[52]	2007	Heart failure LVEF ≤ 45%	20	Embletta; Flaga, Iceland	PSG + PM at sleep lab PM at home
Takama et al[57]	2010	CAD patients	83	Morpheus; Compumedics, Melbourne, Australia	PSG + PM at sleep lab
Danzi-Soares et al[58]	2011	CAD patients	79	Stardust II, Respironics Inc., Murrysville, Pennsylvania, United States	PSG + PM at sleep lab
Oliveira et al[68]	2012	COPD patients	72	Stardust II® (Phillips Respironics, Inc., Murrysville, PA, United States)	PSG + PM at sleep lab PM at home
Lesser et al[78]	2012	Obese pediatric patients (9-18 yr )	25	ApneaLink Plus (PesMed Corporation, Poway, CA)	PSG + PM at sleep lab
Fredheim et al[79] (abstract)	2014	Morbidly obese patients	105	ApneaLink	PM PM + Embletta
Oliveira et al[80]	2014	Obese patients	58	Stardust II® (Phillips Respironics, Inc., Murrysville, PA, United States)	PSG + PM at sleep lab PM at home

PM: Portable monitoring; PSG: Polysomnography; LVEF: Left ventricle ejection fraction; CAD: Coronary artery disease; COPD: Chronic obstructive pulmonary disease.