The following is a summary of “Comparing the diagnostic value of the positional obstructive sleep apnea definitions,” published in the March 2023 issue of Pulmonology by Oweidat, et al.

The diagnosis of Positional Obstructive Sleep Apnea (pOSA) can be made using different definitions, but the comparative diagnostic value of these definitions needs to be well-documented. Therefore, for a study, researchers sought to compare four criteria regarding their diagnostic value. 

The study analyzed 1,092 sleep studies conducted between 2016 and 2022 at Jordan University Hospital’s sleep lab, excluding patients with an AHI <5. According to the reference rule, the prevalence of pOSA in the study sample was 49.9%. Four different definitions were used to diagnose pOSA, namely, the Amsterdam Positional OSA Classification (APOC), supine AHI twice the non-supine AHI (Cartwright), Cartwright plus the non-supine AHI <5 (Mador), and overall AHI severity at least 1.4 times the non-supine severity (Overall/NS-AHI). 

The retrospective analysis of 1,033 polysomnographic sleep studies revealed that all four definitions had a diagnostic accuracy above 50%. The Overall/Non-Supine definition had the highest sensitivity (83.5%), specificity (99.81%), positive predictive value (99.77%), negative predictive value (85.88%), and accuracy (91.68%) among the four definitions.

The study findings indicated that the Overall/Non-Supine criteria were superior to the other definitions in diagnosing pOSA. Selecting the appropriate criteria for diagnosing pOSA could result in fewer patients being assigned to CPAP and more patients being assigned to positional therapy methods.

Source: resmedjournal.com/article/S0954-6111(23)00115-4/fulltext