Study: overnight oximetry vs polysomnography for diagnosis

I searched the forum but didn't find anything; has this study been discussed?

Background
Polysomnography (PSG) is treated as the gold standard for diagnosing obstructive sleep apnea (OSA). However, it is labor-intensive, time-consuming, and expensive. This study evaluates validity of overnight pulse oximetry as a diagnostic tool for moderate to severe OSA patients.

Conclusions
Overnight pulse oximetry provides satisfactory diagnostic performance in detecting severe OSA patients. Home-styled oximetry may be a tool for severe OSA diagnosis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4407425/

And another one:

Objectives
Increasing awareness of the high prevalence of obstructive sleep apnea (OSA) and its impact on health in conjunction with high cost, inconvenience, and short supply of in-lab polysomnography (PSG) has led to the development of more convenient, affordable, and accessible diagnostic devices. We evaluated the reliability and accuracy of a single-channel (finger pulse-oximetry) photoplethysmography (PPG)-based device for detection of OSA (Morpheus Ox).

Conclusions
PPG-derived data compare well with simultaneous in-lab PSG in the diagnosis of suspected OSA among patients with and without cardiopulmonary comorbidities.

http://jcsm.aasm.org/viewabstract.aspx?pid=29378

Obviously an overnight study at sleep lab is ideal, but good to know that finger pulse-oximetry is also helpful with diagnosis, for those who are unable to get a proper study done.

There are tons of patients that get false negatives off home sleep testing, because they don’t REM. Most home testing units don’t have eeg leads to capture that stage of sleep and it’s the worst for OSA. There are plenty of people that have severe OSA in REM and not so much in their other sleep, and get misdiagnosed all the time because of home sleep testing, only because they didn’t dream the night they had the testing unit on. Antidepressants can routinely cause a patient to skip nights dreaming.

The key words are "severe OSA..."

Oximetry is a powerful tool that provides a lot of information on how your body is performing. There is a reason it is included in the PSG.

If you fail oximetry, you have a problem.

However, if you pass oximetry on a single night study that doesn't mean you don't have a problem.

If you want to try to extend the usefulness of oximetry you need to collect data every night for a couple of weeks. Now focus on your heart rates and how they vary with oxygen saturation variation. Still not as good as PSG, but you can start mapping out trends that may help.

Simply put, an oximeter can prove that you need CPAP, but it can never prove that you don't.

Dreaming1 wrote: ↑

Fri Mar 08, 2019 6:21 am

... only because they didn’t dream the night they had the testing unit on. Antidepressants can routinely cause a patient to skip nights dreaming.

One can, and will, dream in any sleep stage, it's just more common in REM.