Littner Michael R
VA Greater Los Angeles Healthcare System, VA Medical Center (111P) Bldg. 200, 16111 Plummer Street, Sepulveda, CA 91343, USA.
Semin Respir Crit Care Med. 2005 Feb;26(1):56-67. doi: 10.1055/s-2005-864200.
Portable monitors are classified into three levels (Level II, III, and IV) with decreasing measurements of sleep and respiratory variables. A full overnight sleep study with respiratory measurements and sleep staging (polysomnography) unattended by a sleep technician is Level II, three or more respiratory channels and heart rate generally without sleep staging either attended or unattended is Level III, and one or two channels attended or unattended, usually including oximetry, is Level IV. To date, some Level III portable monitors appear to have sufficient specificity to diagnose the obstructive sleep apnea (OSA) syndrome but are not sufficiently sensitive to exclude OSA. Attended portable monitoring appears to provide better sensitivity and specificity than unattended portable monitoring and is an option for diagnosis of OSA. The role of portable monitoring is evolving but at this time cannot substitute for attended polysomnography as a standalone approach. The exact place of portable monitoring and the cost-benefit depends on local circumstances and cannot be generalized at this time.
便携式监测设备分为三个级别(二级、三级和四级),睡眠和呼吸变量的测量值逐渐减少。由睡眠技术人员进行的整夜睡眠呼吸测量和睡眠分期的完整研究(多导睡眠图)为二级,通常有三个或更多呼吸通道和心率监测且有无睡眠技术人员参与均可的为三级,有一两个通道监测且有无睡眠技术人员参与均可,通常包括血氧饱和度监测的为四级。迄今为止,一些三级便携式监测设备似乎具有足够的特异性来诊断阻塞性睡眠呼吸暂停(OSA)综合征,但对排除OSA的敏感性不足。有睡眠技术人员参与的便携式监测似乎比无睡眠技术人员参与的便携式监测具有更高的敏感性和特异性,是诊断OSA的一种选择。便携式监测的作用正在不断演变,但目前不能替代有睡眠技术人员参与的多导睡眠图作为独立的诊断方法。便携式监测的确切地位和成本效益取决于当地情况,目前无法一概而论。