Advances in Diagnostic Techniques in Sleep Disorders最新文献

Contribution of carotid body to leptin effects on ventilation and blood pressure in control and obese rats 颈动脉体对瘦素对正常和肥胖大鼠通气和血压影响的贡献

Advances in Diagnostic Techniques in Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.sleepandbreathing-2019.p77

M. Ribeiro, J. P. Guimarães, J. Sacramento, S. Conde

引用次数: 2

Sleep apnea and cardiac rythm: Time matters. 睡眠呼吸暂停和心律:时间问题。

Advances in Diagnostic Techniques in Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.sleepandbreathing-2019.p69

Susana Cláudia Teixeira De Sousa Varela, C. Forte, C. Rijo, Mafalda Silva, R. Marinheiro, L. Parreira, P. Duarte

引用次数: 1

Reliability of automatic detection of AHI during mechanical ventilation 机械通气时AHI自动检测的可靠性

Advances in Diagnostic Techniques in Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.SLEEPANDBREATHING-2019.P75

F. Fanfulla, S. Arcovio, Nadia D'Artavilla Lupo, C. Pronzato, A. Prpa, Paola Mogavero, I. Risi, R. Trentin

{"title":"Reliability of automatic detection of AHI during mechanical ventilation","authors":"F. Fanfulla, S. Arcovio, Nadia D'Artavilla Lupo, C. Pronzato, A. Prpa, Paola Mogavero, I. Risi, R. Trentin","doi":"10.1183/23120541.SLEEPANDBREATHING-2019.P75","DOIUrl":"https://doi.org/10.1183/23120541.SLEEPANDBREATHING-2019.P75","url":null,"abstract":"Automatic detection of residual AHI by the CPAP or NIV ventilators is a current practice both in the setting of titration procedures or follow-up monitoring. However, the reliability of this estimation has not been validated in a wide and composite population of OSA patients. We analyzed data of 300 patients already on treatment with different modalities of mechanical ventilation at home: 53% received CPAP, 28.5% auto-BiPAP, 8.8% PSV, 7,8% APAP and 1.7% of them ASV ventilation. Oro-nasal mask was used in 53.6% of patients. All the patients underwent home full PSG or HRP: the respiratory data were compared with those registered by the ventilatory machine. Overall, the mean AHI detected during PSG (AHIPSG) was higher than that detected by ventilator (AHIVent): 6.8±9.2 vs 4.3±6.3; p 5 (26.1% of total sample considering and AHI>15); 7% of patients were classified as not controlled despite the presence of AHIPSG Automatic detection of residual AHI by in-built software is frequently unreliable independently by ventilation modality or interfaces.","PeriodicalId":220355,"journal":{"name":"Advances in Diagnostic Techniques in Sleep Disorders","volume":"17 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124340438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

WatchPAT (WP) vs. Limited Polysomnography (LPS): observations from a pilot study WatchPAT (WP)与有限多导睡眠描记(LPS):一项初步研究的观察结果

Advances in Diagnostic Techniques in Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.SLEEPANDBREATHING-2019.P64

J. Samuel, S. Mukhtar, U. Dawar, Sharon Tungate, L. Roberts, B. Ibrahim

{"title":"WatchPAT (WP) vs. Limited Polysomnography (LPS): observations from a pilot study","authors":"J. Samuel, S. Mukhtar, U. Dawar, Sharon Tungate, L. Roberts, B. Ibrahim","doi":"10.1183/23120541.SLEEPANDBREATHING-2019.P64","DOIUrl":"https://doi.org/10.1183/23120541.SLEEPANDBREATHING-2019.P64","url":null,"abstract":"Introduction: Referrals to sleep centres have increased in the UK. The waiting time to be seen far exceeds the stipulated 18 week Referral to Treatment (RTT). In our centre, patients referred for suspected OSA have a pre-clinic pulse oximetry. Those with a high Epworth Sleepiness score (ESS) are referred for LPS. WP a wrist mounted device measures arterial tone at the fingertip. Studies have validated the algorithm results by comparison with full PSG obviating the need for manual scoring. We conducted a pilot study comparing WP with LPS to assess patient preference, reliability of measured parameters and effect on RTT. Methods: Patients who did not have a diagnosis after pre-clinic pulse oximetry review were tested simultaneously with home LPS and WP. LPS tests were manually scored and compared with the automated report from the WP software. Results: 11 patients participated in the pilot study. Mean age was 40, mean BMI 35 and mean ESS was 14. Mean AHI on LPS was 15 and WP 17. Mean ODI on LPS was 18 and WP 7. Mean RDI on WP was 25. (see Table1). All patients were started on CPAP. Discussion: While the co-relation between AHI was good, WP underestimated ODI. The RDI on WP was an advantage. Manual scoring of LPS can incur a delay of a week plus clinician time. Patients were comfortable with WP as compared to LPS. Although this was a small pilot study, in view of the ease of use, shortening of the patient pathway time, good correlation of AHI, our centre is planning on using the WP device in regular practice.","PeriodicalId":220355,"journal":{"name":"Advances in Diagnostic Techniques in Sleep Disorders","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125168471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correlation analysis of sleep breathing sound and polysomnographic features 睡眠呼吸声与多导睡眠图特征的相关性分析

Advances in Diagnostic Techniques in Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.SLEEPANDBREATHING-2019.P55

Jeong-Whun Kim, Sung-Woo Cho, Kyogu Lee, Jaeyoung Shin

{"title":"Correlation analysis of sleep breathing sound and polysomnographic features","authors":"Jeong-Whun Kim, Sung-Woo Cho, Kyogu Lee, Jaeyoung Shin","doi":"10.1183/23120541.SLEEPANDBREATHING-2019.P55","DOIUrl":"https://doi.org/10.1183/23120541.SLEEPANDBREATHING-2019.P55","url":null,"abstract":"OBJECTIVE: To find relationship between sleep breathing sounds and various polysomnographic features. METHOD: Patients who underwent PSG with audio recording using a microphone were included. After noise reduction preprocessing, the data were segmented into 5-second windows and sound features were extracted. A simple linear regression of various sound features were performed with various PSG features including apnea hypopnea index (AHI), apnea index (AI), hypopnea index (HI), Oxygen desaturation index (ODI), and respiratory arousal (RA). Also prediction of PSG features from sleep breathing sounds had been established using machine learning. RESULT: A total of 116 subjects were included. A total of 508 sound features were extracted. Among them, Derivative of Area Method of Moments Overall Standard Deviation was the most distinguishing feature that explained AHI (R2= 0.628), AI (R2=0.620), ODI (R2= 0.641), SpO2 CONCLUSION: Similar prediction values were acquired with simple linear regression and machine learning. Especially machine learning resulted in a better performance regarding to AI and Time of SpO2","PeriodicalId":220355,"journal":{"name":"Advances in Diagnostic Techniques in Sleep Disorders","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115753879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Tele-medical application for interdisciplinary diagnosis in sleep related diseases. 远程医疗在睡眠相关疾病跨学科诊断中的应用。

Advances in Diagnostic Techniques in Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.sleepandbreathing-2019.p50

M. Blaukovitsch, W.L. Klampfer, F. Kral

{"title":"Tele-medical application for interdisciplinary diagnosis in sleep related diseases.","authors":"M. Blaukovitsch, W.L. Klampfer, F. Kral","doi":"10.1183/23120541.sleepandbreathing-2019.p50","DOIUrl":"https://doi.org/10.1183/23120541.sleepandbreathing-2019.p50","url":null,"abstract":"Introduction: The need for interdisciplinary work-up of sleep related diseases (SRD) is a growing problem. Sometimes sleep experts are not available locally to operate an interdisciplinary sleep laboratory (iSLAB). Tele medicine could allow individual IT solutions for evaluation of sleep data and therapy. Objectives: In this feasibility study we evaluated the implementation of an iSLAB using telemedical transfer for the first time in Austria. Methods: We launched 3 iSLAB units at the departement of ENT, Kardinal Schwarzenberg Klinikum. Polysomnographic data were processed locally and send to an ISO-server (IEC 27001), which were then analysed over VPN (virtual private network) by the sleep managing doctor (SMD). Diagnosis and treatment options were exported via HL7-connection and included in patient´s records, which were then discussed in a sleep ambulance. Results: So far we processed 140 patients. Main diagnosis was moderate to severe OSA (49 patients). Others were chronic insomnia (19 pat.), hypoventilation-syndroms (11 pat.), heavy snorer (28 pat.) and RLS (5 pat.). 35 patients received ventilator-therapy, 14 patients were evaluated for UPPP with sleep endoscopy or received a mandibular device. Conclusion: For patients it is ideal to recieve all therapy modalities at one single place and medical doctors from different subspecialities learn from each other permanently and therefore can offer cutting edge therapy with the help of IT solutions, even when sleep experts are not physically present.","PeriodicalId":220355,"journal":{"name":"Advances in Diagnostic Techniques in Sleep Disorders","volume":"30 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114012825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validity of pulse-transit-time based blood pressure measurements in patients with and without heart failure across different breathing maneuvers 脉搏传递时间为基础的血压测量在有和没有心衰患者在不同的呼吸操作的有效性

Advances in Diagnostic Techniques in Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.SLEEPANDBREATHING-2019.P68

J. Spiesshoefer, S. Becker, P. Young, M. Boentert, A. Giannoni

{"title":"Validity of pulse-transit-time based blood pressure measurements in patients with and without heart failure across different breathing maneuvers","authors":"J. Spiesshoefer, S. Becker, P. Young, M. Boentert, A. Giannoni","doi":"10.1183/23120541.SLEEPANDBREATHING-2019.P68","DOIUrl":"https://doi.org/10.1183/23120541.SLEEPANDBREATHING-2019.P68","url":null,"abstract":"Purpose: Using pulse transit time (PTT) and an ECG has been declared a promising alternative for invasive or noninvasive monitoring of blood pressure (BP). This study assessed the validity of PTT for BP monitoring in different subsets of patients under sleep laboratory like conditions. Methods: Ten healthy volunteers (HV; 7 male, 55.8±19.6 years), twelve patients with systolic heart failure (HF; 10 male, 67.3 ± 8.6 years, LVEF 37.9±11.8%) and fourteen patients with pulmonary arterial hypertension (PAH; 5 male, 59.5±13.4 years) performed different breathing patterns designed to simulate nocturnal sleep disordered breathing (SDB). BP was measured using two devices (oscillometrically via Task Force Monitor™, CNSystems and PTT via SOMNOscreen™, Somnomedics) at least every 15 minutes for 30 minutes before, during and after different breathing maneuvers. Results: Mean systolic BP was 111.3±15.1 mmHg vs. 110.0±14.7 mmHg for oscillometric method vs PTT, respectively. Corresponding values for diastolic BP were 69.9±12.2 mmHg and 69.9±14.2 mmHg. The two methods were hence neither clinically nor statistically (p>0.05) significantly different. Conclusions: When monitoring BP in patients without HF, with HF and with PAH, overall BP monitoring using PTT is comparable to oscillometry for a period of 1.5 hours (including a 0.5 hours SDB phase).","PeriodicalId":220355,"journal":{"name":"Advances in Diagnostic Techniques in Sleep Disorders","volume":"210 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121209022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peripheral arterial tonometry compared to polysomnography in chronic obstructive pulmonary disease. 外周动脉血压计与多导睡眠图在慢性阻塞性肺疾病中的比较。

Advances in Diagnostic Techniques in Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.SLEEPANDBREATHING-2019.P54

N. H. Holmedahl, Odd-Magne Fjeldstad, H. Engan, I. Saxvig, J. Grønli

{"title":"Peripheral arterial tonometry compared to polysomnography in chronic obstructive pulmonary disease.","authors":"N. H. Holmedahl, Odd-Magne Fjeldstad, H. Engan, I. Saxvig, J. Grønli","doi":"10.1183/23120541.SLEEPANDBREATHING-2019.P54","DOIUrl":"https://doi.org/10.1183/23120541.SLEEPANDBREATHING-2019.P54","url":null,"abstract":"Introduction: At least half of Chronic Obstructive Pulmonary Disease (COPD) patients experience reduced sleep quality, and obstructive sleep apnea (OSA) worsens outcomes. Thus, objective sleep monitoring is often needed, but polysomnograpy is costly and often unavailable. The WatchPattm determines sleep by a pre-programmed algorithm based on peripheral arterial tone, pulse rate, oxygen saturation, motor activity, snoring and body position. In patients with OSA, the WatchPat demonstrated moderate agreement in detecting sleep stages[1]. Here, we validated WatchPat against polysomnography (PSG) in COPD patients. Methods: In all, 16 COPD patients (7 men), mean age 61 years old, underwent simultaneous overnight recordings with PSG and the WatchPat. PSG defined N1 and N2 were classified as light sleep for epoch-by-epoch comparisons. PSG sleep was scored according to AASM guidelines by two RPSGT, blinded to the automated scoring by the WatchPat. Results: WatchPat obtained 92% sensitivity (WatchPat = sleep when PSG = sleep), 44% specificity (WatchPat = wake when PSG = wake), 84% positive predictive value and 61% negative predictive value as compared to PSG. Between WatchPat and PSG, the overall epoch-by-epoch agreement for all sleep stages was 59%, with Cohen ? coefficient 0,347. Between the two PSG scorers the overall agreement was 91%, Cohen ? 0,856. Conclusion: The WatchPat detect sleep stages with only fair agreement with PSG in COPD-patients. [1] Hedner, J. et al. JCSM 2011;3:301-306","PeriodicalId":220355,"journal":{"name":"Advances in Diagnostic Techniques in Sleep Disorders","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124747262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Decreased plasma levels of anti-inflammatory klotho protein in obstructive sleep apnoea 阻塞性睡眠呼吸暂停患者血浆抗炎klotho蛋白水平降低

Advances in Diagnostic Techniques in Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.SLEEPANDBREATHING-2019.P74

A. Bikov, L. Kunos, I. Horváth, J. Pako

{"title":"Decreased plasma levels of anti-inflammatory klotho protein in obstructive sleep apnoea","authors":"A. Bikov, L. Kunos, I. Horváth, J. Pako","doi":"10.1183/23120541.SLEEPANDBREATHING-2019.P74","DOIUrl":"https://doi.org/10.1183/23120541.SLEEPANDBREATHING-2019.P74","url":null,"abstract":"Introduction: Klotho is protein involved in anti-inflammatory processes of the human body. OSA is associated with an enhanced systemic inflammation, but mechanism which regulate inflammation and oxidative stress are poorly described. The aim of the study was to investigate the plasma levels of klotho in OSA Methods: Twenty-one previously untreated patients with OSA (56±13 years, 12 males) and 41 non-OSA control volunteers (48±16 years, 8 males) participated in the study. OSA has been diagnosed or excluded with polysomnography. C-reactive protein and standard biochemistry tests have been performed in sera, klotho has been determined in citrate-treated plasma samples with ELISA. Results: The levels of plasma klotho were decreased in OSA vs. controls (506 /205-980/ pg/ml vs. 559 /333-2256/ pg/ml, p=0.02). Decreased klotho was associated with overnight hypoxemia determined with ODI (r=-0.31, p=0.01), TST90% (r=-0.41, p 0.05). Significant associations were also found between plasma klotho levels and the presence of hypertension as well as increased levels of triglyceride (both p Conclusions: Decreased klotho levels may also correspond to enhanced systemic inflammation in OSA which has to be investigated in future studies.","PeriodicalId":220355,"journal":{"name":"Advances in Diagnostic Techniques in Sleep Disorders","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129252116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Polygraphy as standard in OSA diagnostics? 测谎作为OSA诊断的标准?

Advances in Diagnostic Techniques in Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.SLEEPANDBREATHING-2019.P65

A. Slats, L. Hermsen

{"title":"Polygraphy as standard in OSA diagnostics?","authors":"A. Slats, L. Hermsen","doi":"10.1183/23120541.SLEEPANDBREATHING-2019.P65","DOIUrl":"https://doi.org/10.1183/23120541.SLEEPANDBREATHING-2019.P65","url":null,"abstract":"Introduction: The Dutch National Health Care Institute has a program “Zinnige Zorg”, in which ICD domains are systematically analyzed to improve health care. For obstructive sleep apneu(OSA), the complete care-pathway was examined to identify (in)appropriate care. Objectives: To analyze the current literature regarding good care(guidelines and systematic reviews) and compare these to the data on the use of diagnostic tests in daily clinical practice(data-analyses) in OSA care in the Netherlands. Methods: The Dutch Cochrane group performed the guideline analyses and systematic reviews on clinical use of diagnostic tests(diagnostic test followed by treatment or no treatment, and evaluation on patient relevant outcomes in both arms), in randomized controlled trials(RCTs). Data-analyses were based on hospital declaration data. Results: The Cochrane group found two RCTs that examined the clinical use of PSG vs PG: total number of patients 701, also low-risk probability included, as well as OSA related co-morbidities. Non-inferiority of PG vs PSG was found for daytime sleepiness(ESS) and Quality of Life(FOSQ), GRADE; high. A difference in effect could not be found nor discharged for cardiovascular endpoints, AHI, ODI or CPAP compliance. Data analysis: maximum capacity of 40.000 newly analyzed OSA pts/yr, 50:50 proportion of PG:PSG, an institution-based variation in the use of PG:PSG. Conclusion: In the context of increased demand and limited capacity in OSA diagnostics, these findings warrant to explore the use of PG as standard in OSA diagnostics.","PeriodicalId":220355,"journal":{"name":"Advances in Diagnostic Techniques in Sleep Disorders","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121100209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0