0475 COMPARISON OF PERIPHERAL ARTERIAL TONOMETRY AND POLYSOMNOGRAPHY FOR THE DIAGNOSIS OF OSA IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Chronic obstructive pulmonary disease (COPD) is a prevalent disorder with high morbidity and mortality. Studies suggest that concomitant untreated sleep-disordered breathing (SDB) substantially worsens outcomes. In addition to cost and availability, PSG may be an unattractive option for SDB diagnosis given rapid oxygen desaturation with relatively little upper airway obstruction - and low inter-rater reliability of PSG in this patient group as a result. Thus, alternative diagnostic methods are needed. The WatchPAT (Itamar Medical) is a home sleep testing device which has been shown to be accurate for diagnosing SDB in normal population without significant lung disease. It is based on peripheral arterial tone (PAT), pulse rate, oxygen saturation, actigraphy, snoring recording, and body position. Previous WatchPAT studies excluded patients with COPD. We therefore sought to compare WatchPAT to PSG in detecting SDB in patient with COPD. 32 patients (19 men) previously diagnosed with COPD, aged 64 ± 7 years old, underwent simultaneous recording with full night in-lab PSG and WatchPAT. PSG scoring was performed according to Chicago criteria by a RPSGT (AHI-PSG), who was blinded to the automated scoring by WatchPAT software (AHI-WPAT). All COPD patients also completed pulmonary function tests, Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) questionnaires. Pearson correlation between AHI-PSG and AHI-WPAT was p =0.638, p ≤ 0.001; Pearson correlation between REM AHI-PSG and REM AHI and ODI by WatchPAT for all 32 patients were 0.824 and 0.869, p ≤ 0.001. Using a threshold of AHI ≥ 10, the sensitivity and specificity of WatchPAT for all 32 patient were 0.89 and 0.78, respectively. No significant correlations were found between AHI-PSG or AHI-WPAT with PSQI or ESS scores. These findings suggest that WatchPAT may be used to accurately detect SDB in patients with COPD, especially in those with REM predominant events. More studies using WatchPAT with underlying lung diseases will be required to determine if this can be used as a screening test for SDB in COPD patients, especially those who are at risk for hypoventilation, and what factors might cause discrepancy between WatchPAT with PSG. None

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