Abstract: Background: Sleepiness-at-the-wheel has been identified as a major cause of highway accidents. The aim of our study is identifying the candidate measures for home-based screening of sleep disordered breathing in Taiwanese bus drivers, instead of polysomnography. Methods: Overnight polysomnography accompanied with simultaneous measurements of alternative screening devices (pulse oximetry, ApneaLink, and Actigraphy), heart rate variability, wake-up systolic blood pressure and questionnaires were completed by 151 eligible participants who were long-haul bus drivers with a duty period of more than 12 h a day and duty shifting. Results: 63.6% of professional bus drivers were diagnosed as having sleep disordered breathing and had a higher body mass index, neck circumference, systolic blood pressure, arousal index and desaturation index than those professional bus drivers without evidence of sleep disordered breathing. Simple home-based candidate measures: (1) Pulse oximetry, oxygen-desaturation indices by ≥3% and 4% (r = 0.87~0.92); (2) Pulse oximetry, pulse-rising indices by ≥7% and 8% from a baseline (r = 0.61~0.89); and (3) ApneaLink airflow detection, apnea-hypopnea indices (r = 0.70~0.70), based on recording-time or Actigraphy-corrected total sleep time were all significantly correlated with, and had high agreement with, corresponding polysomnographic apnea-hypopnea indices [(1) 94.5%~96.6%, (2) 93.8%~97.2%, (3) 91.1%~91.3%, respectively]. Conversely, no validities of SDB screening were found in the multi-variables apnea prediction questionnaire, Epworth Sleepiness Scale, night-sleep heart rate variability, wake-up systolic blood pressure and anthropometric variables. Conclusions: The indices of pulse oximetry and apnea flow detection are eligible criteria for home-based screening of sleep disordered breathing, specifically for professional drivers.
Keywords: diagnostic techniques and procedures; polysomnography; oximetry; obstructive sleep apnea
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Ting, H.; Huang, R.-J.; Lai, C.-H.; Chang, S.-W.; Chung, A.-H.; Kuo, T.-Y.; Chang, C.-H.; Shih, T.-S.; Lee, S.-D. Evaluation of Candidate Measures for Home-Based Screening of Sleep Disordered Breathing in Taiwanese Bus Drivers. Sensors 2014, 14, 8126-8149.
Ting H, Huang R-J, Lai C-H, Chang S-W, Chung A-H, Kuo T-Y, Chang C-H, Shih T-S, Lee S-D. Evaluation of Candidate Measures for Home-Based Screening of Sleep Disordered Breathing in Taiwanese Bus Drivers. Sensors. 2014; 14(5):8126-8149.
Ting, Hua; Huang, Ren-Jing; Lai, Ching-Hsiang; Chang, Shen-Wen; Chung, Ai-Hui; Kuo, Teng-Yao; Chang, Ching-Haur; Shih, Tung-Sheng; Lee, Shin-Da. 2014. "Evaluation of Candidate Measures for Home-Based Screening of Sleep Disordered Breathing in Taiwanese Bus Drivers." Sensors 14, no. 5: 8126-8149.