Yin Min, Miyazaki Soichiro, Itasaka Yoshiaki, Shibata Yutaka, Abe Takashi, Miyoshi Akira, Ishikawa Kazuo, Togawa Kiyosi
Department of Otorhinolaryngology, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.
Auris Nasus Larynx. 2005 Jun;32(2):151-6. doi: 10.1016/j.anl.2004.11.004.
Portable monitoring (PM) for diagnosis of obstructive sleep apnea has developed recently. Many studies were performed in the laboratory setting, with simultaneous polysomnographic recordings or required technical assistance in the home setting. And the data were automatically analyzed. In this study, we attempted to evaluate whether PM could be useful in fully unattended home setting, and whether the auto analysis of the data is reliable. Home setting examination by Stardust II, a novel PM device, was performed unattendedly on consecutive 62 patients who complained of snoring. The questionnaire survey on the difficulty of fitting and operation, and the discomfort was conducted by visual analog scale. Automatically and manually analyzed results were compared. The examination was successfully performed by all subjects. The difficulty of fitting and operation, and the discomfort were 2.9+/-1.9, 1.8+/-1.2 and 3.6+/-2.1, respectively. Auto analysis differed significantly from manual analysis not only in apnea/hypopnea index (AHI), but also in the construction of sleep disordered respiratory events. Although AHI in automatic and manual analysis had a good correlation (r=0.949; P<0.001), their agreement was poor, especially in mild and moderate cases. However, setting AHI=50 as a cut-off point in auto analysis, sensitivity and specificity could reach 100% and 92.5%, respectively. Accordingly, PM is useful to identify obstructive sleep apnea in an unattended home setting condition. Considering the significant difference between automatic and manual analysis, we suggest that the data analysis should be performed manually.
用于诊断阻塞性睡眠呼吸暂停的便携式监测（PM）技术近年来得到了发展。许多研究是在实验室环境中进行的，同时记录多导睡眠图，或者在家庭环境中需要技术协助。并且数据是自动分析的。在本研究中，我们试图评估PM在完全无人值守的家庭环境中是否有用，以及数据的自动分析是否可靠。使用一种新型PM设备Stardust II，对连续62名主诉打鼾的患者进行了无人值守的家庭环境检查。通过视觉模拟量表对佩戴和操作的难度以及不适感进行了问卷调查。比较了自动分析和手动分析的结果。所有受试者均成功完成检查。佩戴和操作的难度以及不适感分别为2.9±1.9、1.8±1.2和3.6±2.1。自动分析与手动分析不仅在呼吸暂停/低通气指数（AHI）方面存在显著差异，在睡眠呼吸紊乱事件的构成方面也存在差异。虽然自动分析和手动分析中的AHI具有良好的相关性（r = 0.949；P < 0.001），但它们的一致性较差，尤其是在轻度和中度病例中。然而，将自动分析中的AHI = 50作为截断点时，敏感性和特异性分别可达到100%和92.5%。因此，PM在无人值守的家庭环境条件下对于识别阻塞性睡眠呼吸暂停是有用的。考虑到自动分析和手动分析之间的显著差异，我们建议手动进行数据分析。
