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Nocturnal Home Oximetry in Detecting the Sleep Apnea-Hypopnea Syndrome and in Working Up Hypersomnolence
- Neil T. Feldman, MD; and
- Harpreet Singh, MD
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TO THE EDITOR:
Series and colleagues [1] concluded that nocturnal home oximetry screening in patients suspected to have the obstructive sleep apnea-hypopnea syndrome would decrease the number of patients who required complete polysomnographic monitoring. They suggested, however, that because of its low specificity and consequent low positive predictive value, positive home oximetry must be followed by complete polysomnographic monitoring. They studied 240 outpatients referred because of reported sleep disturbances or daytime hypersomnia and confirmed the syndrome in 110. The diagnosis and follow-up of the remaining 130 patients were not defined by the study.
Patients not found to have the syndrome represent an equally important group. Daytime sleepiness, even in the absence of sleep apnea, is not a trivial complaint. Narcolepsy, idiopathic central nervous system hypersomnia, periodic leg movement disorder, and the insufficient sleep syndrome are significant disorders that may also occur in individuals with concomitant snoring. Nocturnal polysomnography with multiple sleep latency testing is necessary in these patients to establish a diagnosis.
In our opinion, nocturnal polysomnography and multiple sleep latency testing are still indicated, even if the screening test result is negative. Thus, screening nocturnal oximetry can only add to the expense of the clinical evaluation.
Neil T. Feldman, MD
Harpreet Singh, MD
St. Petersburg Sleep Disorders Center; St. Petersburg, FL 33707
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
