Mitani Hiroko, Ishiyama Yoji, Shirai Yasuyuki
Department of Clinical Physiology, School of Health Sciences, Kyorin University, Hachioji 192-8508.
Rinsho Byori. 2003 Aug;51(8):790-7.
The monitoring technique for assessing suspected sleep apnea syndrome is a polysomnogram (PSG) performed in hospital. The typical PSG includes EEG, EOG, EMG, air flow at the nose and mouth, SO2, thoracicoabdominal motion and snoring sound. But the PSG test is expensive, and also is a stress load for the patient because this test requires recording throughout the night. Recently, a home-type apnomonitor that is used at home has been developed for the screening of apnea, but this monitor can not distinguish obstructive sleep apnea (OSA) from central sleep apnea (CSA). We evaluated a new home-type apnomonitor that was able to distinguish OSA from CSA using the change of amplitude in the fingertip plethysmogram and respiratory flow curve attained by oronasal transducer. In this study, the respiratory flow curve became flat under OSA conditions, but the change of amplitude on plethysmogram corresponded to thoracioabdominal motion. On the other hand, the change of amplitude in the plethysmogram did not corresponded with thoracicoabdominal motion under CSA conditions. These findings suggest that it is possible to distinguish between OSA and CSA using an apnomonitor system which records a respiratory flow curve and a plethysmogram, and also to develop a new home-type apnomonitor.
用于评估疑似睡眠呼吸暂停综合征的监测技术是在医院进行的多导睡眠图（PSG）检查。典型的PSG包括脑电图（EEG）、眼电图（EOG）、肌电图（EMG）、口鼻气流、血氧饱和度（SO2）、胸腹运动和鼾声。但PSG检查费用高昂，且对患者来说是一种压力负担，因为该检查需要整夜记录。最近，已开发出一种在家中使用的家用型呼吸暂停监测仪用于呼吸暂停的筛查，但这种监测仪无法区分阻塞性睡眠呼吸暂停（OSA）和中枢性睡眠呼吸暂停（CSA）。我们评估了一种新型家用型呼吸暂停监测仪，它能够利用经口鼻换能器获得的指尖容积描记图和呼吸流量曲线的幅度变化来区分OSA和CSA。在本研究中，在OSA情况下呼吸流量曲线变平，但容积描记图上的幅度变化与胸腹运动相对应。另一方面，在CSA情况下，容积描记图上的幅度变化与胸腹运动不对应。这些发现表明，使用记录呼吸流量曲线和容积描记图的呼吸暂停监测系统区分OSA和CSA是可能的，并且开发一种新型家用型呼吸暂停监测仪也是可行的。
