Nakano H, Tanigawa T, Ohnishi Y, Uemori H, Senzaki K, Furukawa T, Nishima S
Dept of Pulmonology, Fukuoka National Hospital, Fukuoka, Japan.
Eur Respir J. 2008 Oct;32(4):1060-7. doi: 10.1183/09031936.00130907. Epub 2008 May 14.
A simple screening method for sleep-disordered breathing (SDB) is desirable for primary care practices. In the present study, a simple monitor, which utilises a new type of flow sensor and a novel algorithm, was prospectively validated. Home recording for 2 nights with the monitor only, followed by in-laboratory recording with the monitor together with polysomnography, were carried out in consecutive patients (n = 100) suspected of SDB. A subjective sleep log was also recorded. The signal was analysed using power spectral analysis, which yielded the flow respiratory disturbance index (flow-RDI). There was no recording failure at home. The reproducibility of the flow-RDI between the 2 nights at home was high (intraclass correlation coefficient = 0.92). The sensitivity and specificity of the in-laboratory flow-RDI to diagnose SDB were 0.96 and 0.82, 0.91 and 0.82, and 0.89 and 0.96, for apnoea/hypopnoea index (AHI) > or =5, > or =15 and > or =30 events x h(-1), respectively. The diagnostic ability in low-severity subgroups (female, normal weight, AHI <15 events x h(-1)) was almost comparable to that in the entire group. Excluding subjective waking time on the sleep log from the recording time had no significant effect on the flow-RDI. The single-channel monitor is considered feasible for ambulatory sleep disordered breathing monitoring because of its easy applicability, high reproducibility and relatively high agreement with polysomnography results.
对于基层医疗实践而言,一种用于筛查睡眠呼吸障碍(SDB)的简单方法是很有必要的。在本研究中,一种采用新型流量传感器和新颖算法的简易监测仪得到了前瞻性验证。对连续100例疑似SDB的患者进行了如下操作:仅使用该监测仪在家记录两晚,随后在实验室将该监测仪与多导睡眠图一起记录。同时还记录了主观睡眠日志。使用功率谱分析对信号进行分析,得出流量呼吸紊乱指数(flow-RDI)。在家记录期间没有出现记录失败的情况。在家两晚的flow-RDI重现性很高(组内相关系数 = 0.92)。对于呼吸暂停/低通气指数(AHI)≥5、≥15和≥30次事件·小时⁻¹,实验室flow-RDI诊断SDB的敏感性和特异性分别为0.96和0.82、0.91和0.82、0.89和0.96。在低严重程度亚组(女性、体重正常、AHI<15次事件·小时⁻¹)中的诊断能力与整个组几乎相当。从记录时间中排除睡眠日志上的主观清醒时间对flow-RDI没有显著影响。由于其易于应用、重现性高且与多导睡眠图结果的一致性相对较高,这种单通道监测仪被认为对于动态睡眠呼吸障碍监测是可行的。