Oztürk Onder, Mutlu Levent Cem, Sağcan Gülseren, Deniz Yüksel, Cuhadaroğlu Cağlar
Department of Chest Diseases, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
Tuberk Toraks. 2009;57(3):306-13.
Full night polysomnography (PSG) remains the gold standard diagnostic test for the evaluation of sleep and the detection of sleep disorders. The computer-assisted scoring methods have been developed to accelerate the scoring. It is said that there was a concordance up to 80% between these scoring softwares and manual scoring. According to our experiences, it is not matched with this belief. In this study, we intend to examine whether the results of automatic analysis match with manual (visual) evaluation. The PSG records of 30 cases with a diagnosis of obstructive sleep apnea syndrome (OSAS) are chosen randomly. We compare the results of automatic analysis with the results of two scorers who have a concordance of 80-95% and at least 1000 PSG scoring experiences. We evaluated 21.060 epochs of 18 men with 48.83 + or - 13.51 ages, and 12 women with 44.56 + or - 14.28 ages. In automatic analysis; total sleep time (p= 0.003) and sleep efficiency (p= 0.004) were low. AHI (p= 0.802) and ODI (p= 0.193) values were high. The epochs scored differently were 8819 epochs (41.88%). The stage I (88.43%) scored mostly different, was allocated to be awake (572 epochs). Stage II and stage IV were scored as stage III in 2276 and 983 epochs respectively. REM epochs were allocated to stage II (574 epochs). The differences in recording times and sleep architecture of PSG tests which examed by automatic analysis will affect all other parameters. Thus, we believe that it will make mistakes in the diagnosis and treatment of sleep disorders.
整夜多导睡眠图（PSG）仍然是评估睡眠和检测睡眠障碍的金标准诊断测试。已开发出计算机辅助评分方法以加快评分速度。据说这些评分软件与人工评分之间的一致性高达80%。根据我们的经验，这一观点并不相符。在本研究中，我们打算检查自动分析结果是否与人工（视觉）评估结果相符。随机选择30例诊断为阻塞性睡眠呼吸暂停综合征（OSAS）的患者的PSG记录。我们将自动分析结果与两位一致性为80%-95%且至少有1000次PSG评分经验的评分者的结果进行比较。我们评估了18名年龄为48.83±13.51岁的男性和12名年龄为44.56±14.28岁的女性的21060个睡眠周期。在自动分析中，总睡眠时间（p = 0.003）和睡眠效率（p = 0.004）较低。呼吸暂停低通气指数（AHI，p = 0.802）和氧减指数（ODI，p = 0.193）值较高。评分不同的睡眠周期有8819个（41.88%）。I期（88.43%）评分差异最大，被判定为清醒（572个睡眠周期）。II期和IV期分别有2276个和983个睡眠周期被判定为III期。快速眼动（REM）睡眠周期被判定为II期（574个睡眠周期）。自动分析所检测的PSG测试记录时间和睡眠结构的差异会影响所有其他参数。因此，我们认为这会在睡眠障碍的诊断和治疗中产生错误。
