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World J Respirol. Mar 28, 2015; 5(1): 17-27
Published online Mar 28, 2015. doi: 10.5320/wjr.v5.i1.17
Update on the use of portable monitoring system for the diagnosis of sleep apnea in specific population
Erika Treptow, Marcia Gonçalves Oliveira, Gustavo Antonio Moreira, Sonia Togeiro, Luiz Eduardo Nery, Sergio Tufik, Lia Bittencourt
Erika Treptow, Marcia Gonçalves Oliveira, Gustavo Antonio Moreira, Sonia Togeiro, Sergio Tufik, Lia Bittencourt, Departamento Psicobiologia, Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo CEP 04042-002, Brazil
Luiz Eduardo Nery, Disciplina de Pneumologia, Departamento de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo CEP 04039-002, Brazil
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest: The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lia Bittencourt, MD, PhD, Departamento Psicobiologia, Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 925, São Paulo CEP 04042-002, Brazil. lia@liabittencourt.com.br
Telephone: +55-11-21490155 Fax: +55-11-55725092
Received: September 28, 2014
Peer-review started: September 28, 2014
First decision: November 19, 2014
Revised: December 10, 2014
Accepted: December 29, 2014
Article in press: January 4, 2015
Published online: March 28, 2015
Abstract

The prevalence and severity of obstructive sleep apnea (OSA) is higher in specific population: children, elderly, obese and patients with pulmonary and cardiovascular diseases, compared to the general population. OSA is associated with greater morbidity and mortality in these patients. Although full-night polysomnography is still the gold standard diagnostic sleep study for OSA, it is a time consuming, expensive and technically demanding exam. Over the last few years, there is growing evidence on the use of portable monitors (PM) as an alternative for the diagnosis of OSA. These devices were developed specially for sleep evaluation at home, at a familiar environment, with easy self-application of monitoring, unattended. The use of PM is stablished for populations with high pre-test probability of OSA. However, there is a lack of studies on the use of PM in age extremes and patients with comorbidities. The purpose of this review is to present the studies that evaluated the use of PM in specific population, as well as to describe the advantages, limitations and applications of these devices in this particular group of patients. Although the total loss rate of recordings is variable in different studies, the agreement with full-night polysomnography justifies the use of PM in this population.

Keywords: Out-of-center sleep testing, Obesity, Home unattended portable monitoring, Elderly, Children, Portable monitoring, Cardiovascular diseases, Chronic obstructive pulmonary disease, Polysomnography

Core tip: This is the first review that evaluated the use of Portable Monitoring as an alternative method for diagnosis of obstructive sleep apnea in specific population. Additionally, we present the physiopathological background, technical considerations and clinical implications on the use of PM in age extremes and patients with comorbidites. We also describe the advantages, limitations and applications of these devices in children, elderly, patients with cardiovascular or respiratory diseases and obese patients.