Obstructive sleep apnea (OSA) is a very common disorder. A study conducted in the city of São Paulo, involving more than 1,000 adult participants, estimated that 33% of the population suffers from sleep apnea. Although the classic symptoms usually include loud and frequent snoring and daytime drowsiness, many OSA patients do not report specific complaints.
Identifying sleep apnea can be challenging, especially in patients who visit the clinic for unrelated respiratory issues. Sleep disturbances may go unnoticed. Any patient who seeks care for asthma, COPD, or the flu is part of the general population and, therefore, may be at risk for OSA, regardless of their clinical history.
The reality is, both in Brazil and around the world, most patients remain undiagnosed or are not even suspected of having OSA.
High-Resolution Nighttime Oximetry
High-resolution nighttime oximetry is a powerful tool that every pulmonologist should consider incorporating into their routine evaluations. Its usefulness in screening apnea and nighttime oximetry makes it a key resource for the diagnosis and management of OSA.
This type of oximetry identifies desaturation episodes and calculates the oxygen desaturation index (ODI), a metric closely related to the apnea-hypopnea index (AHI) obtained in polysomnography. For patients with severe OSA, the use of automatic CPAP at home for one week provides results comparable to traditional CPAP titration conducted in a sleep lab.
Patients who begin CPAP treatment can undergo a second oximetry study, this time while using automatic CPAP. This combined approach, using oximetry and automatic CPAP at home for one week, helps resolve the majority of OSA cases. Moreover, many patients experience improvement by implementing strategies such as weight loss, regular physical activity, nasal obstruction treatment, or the use of a mandibular advancement device. In all of these scenarios, nighttime oximetry enhances clinical follow-up.
High-resolution nighttime oximetry is useful, but its utility is not limited to the diagnosis and management of sleep apnea. It also enables the evaluation of the duration of oxygen saturation below 90% in patients with chronic lung diseases. In these cases, it can detect nocturnal hypoxemia even when oxygen saturation appears normal during a routine clinical visit. Another important application involves patients who use supplemental oxygen. Frequently, the adequacy of oxygen flow during sleep is unknown. For this reason, anyone using oxygen, whether through a concentrator or a cylinder, should undergo a nighttime oximetry evaluation.
By Dr. Geraldo Lorenzi Filho – Pulmonologist
Diretor do Laboratório do Sono do Instituto do Coração, InCor
Livre Docente, Disciplina de Pneumologia, Faculdade de Medicina da USP
Scientific Head of Biologix.
Director Sleep Laboratory, Heart Institute
Associate Professor, Pulmonary Division, Faculty of Medicine, University of Sao Paulo, Brazil
Av. Dr Eneas de Carvalho Aguiar, 44, Laboratório do Sono, oitavo andar
São Paulo, SP, Brazil
CEP, Zip Code : 05403-000
phone: + 55 11 26615486 or 26614004
geraldo.lorenzi@incor.usp.br
Biologix offers an online platform that allows healthcare practitioners to provide their patients with a simplified and low-cost exam for sleep apnea. The Biologix solution is based on portable sensors, apps, and cloud computing.
The diagnosis of obstructive sleep apnea is extremely important. It can be carried out through polysomnography or the Biologix Sleep Test® a multimodal polysomnography. This test can be performed at home, is simple, practical, effective, and does not require spending the night at a sleep lab.
Learn more about the Biologix solution here!
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