清醒脉冲振荡法预测阻塞性睡眠呼吸暂停严重程度。

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-02-01 DOI:10.1016/j.sleep.2024.12.016

Georg Schild , Richard Schreiber , Anke Lux , Sabine Stegemann-Koniszewski , Eva Lücke , Jens Schreiber

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引用次数: 0

摘要

目的/背景：阻塞性睡眠呼吸暂停（OSA）是一种常见病，对健康构成重大威胁。用多导睡眠图或多导睡眠图进行初步诊断既耗时又昂贵。因此，对简化的医疗需求尚未得到满足，特别是将健康患者排除在复杂和不必要的诊断之外。脉冲振荡法（脉冲振荡法）是一种简单、廉价、无创的工具，用于评估OSA患者上呼吸道阻力增加。目的是研究IOS参数与多导睡眠图之间的关系，以评估IOS作为OSA诊断补充工具的适用性。患者/方法：我们对107名参与者进行了前瞻性、横断面、观察性研究。用IOS进行肺功能检查、体体积脉搏图和夜间多导睡眠图。我们计算了IOS和psg结果之间的直接和部分相关性。采用ROC分析评估诊断OSA最有效的预测IOS参数。结果：在ROC分析中，5Hz （R5%）下结合年龄的耐药预测概率AUC最高，为0.919，而R5 （0.4325kPa/(l/s)）为最佳截止值。观察IOS参数与OSA严重程度、氧饱和度持续时间和严重程度的相关性。然而，在排除BMI作为混杂变量后，它们不能作为部分相关再现。结论：本研究结果不能说明IOS在OSA诊断中的有用性。IOS-和psg结果之间缺乏与bmi无关的部分相关性，这表明IOS-和psg结果之间存在无因果谬误的相关性。因此，对IOS的良好测试质量的最初印象可能是无效的。

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Prediction of severity of obstructive sleep apnea by awake impulse oscillometry

Objective/background

Obstructive sleep apnea (OSA) is a common disease, which poses a significant health threat. Initial diagnostics with polygraphy or polysomnography are time consuming and expensive. Therefore, there is an unmet medical need for simplification, especially to exclude healthy patients from elaborate and unnecessary diagnostics. Impulse oscillometry (IOS) is a simple, cheap and noninvasive tool to asses upper airway resistance, which is increased in patients with OSA. The objective was to examine the relationship between IOS parameters and polysomnography in order to evaluate the applicability of IOS as a supplementing tool in OSA diagnostics.

Patients/methods

We performed a prospective, cross-sectional, observational study across 107 participants. Pulmonary function tests with IOS, bodyplethysmography and overnight polysomnography were performed. We computed direct and partial correlations between IOS- and PSG-results. ROC analysis was performed to evaluate the most impactful predictive IOS parameter for diagnosing OSA.

Results

In ROC analysis the predicted probability of resistance at 5Hz (R5%) combined with age showed the highest AUC of 0.919, while R5 at 0.4325kPa/(l/s) provided the optimal cut-off. Correlations between IOS parameters and OSA severity as well as the duration and severity of oxygen desaturation were observed. However, they could not be reproduced as partial correlations after eliminating the BMI as confounding variable.

Conclusion

Our results cannot indicate the usefulness of IOS in OSA diagnostics. The lack of BMI-independent partial correlations between IOS- and PSG-results suggest a correlation without causality fallacy between IOS- and PSG-results. Therefore, the initial impression of good test quality for IOS might be invalid.

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.