Sleep Disorders Center, Meitan General Hospital, Beijing, China.
Sleep Med. 2011 Apr;12(4):384-9. doi: 10.1016/j.sleep.2010.09.011.
The diagnosis of sleep-disordered breathing (SDB) and evaluation of sleep quality in the pediatric population is dependent on resource intensive attended polysomnography. An ECG-derived cardiopulmonary coupling sleep spectrogram (CPC) analysis previously described in adults can provide information about the severity of SDB and coupled interactions of sleep modulated autonomic drive and respiration. We hypothesized that CPC algorithm-derived metrics will correlate with nasal pressure-based apnea-hypopnea scoring in pediatric population.
A total of 63 subjects (mean 6.2 years; range 2-12 years) were analyzed by both CPC and conventional nasal flow and desaturation scoring obtained during cardiorespiratory recordings. The characteristics of CPC indices and correlation with conventional SDB scoring were computed.
High-frequency coupling (HFC), the CPC marker of stable sleep state, is reduced in proportion to SDB. The HFC durations are negatively correlated with the nasal flow-derived respiratory disturbance index (RDI), a CPC-derived RDI (CPC-RDI), and the 3% oxygen desaturation index (correlation coefficient -0.60, -0.78 and -0.54, respectively). CPC-RDI has a strong positive correlation with the conventional nasal-flow RDI (correlation coefficient 0.70). In this group with a mean nasal-flow RDI 36.1/h, the percentage of correct CPC diagnosis was 85.7% in total, 40% in the non-severe group (10 subjects, RDI <20/h) and 94.3% in the severe group (53 subjects, RDI >20/h).
ECG-derived sleep spectrogram metrics are correlated with nasal flow-derived respiratory abnormality in pediatric SDB. In suitable clinical contexts, this method may have screening utility and possibly allow tracking of treatment effects, specifically in the children with severe SDB.
儿童睡眠障碍呼吸（SDB）的诊断和睡眠质量评估依赖于资源密集型的多导睡眠图。先前在成人中描述的基于心电图的心肺耦合睡眠频谱（CPC）分析可提供有关 SDB 严重程度和睡眠调节自主驱动与呼吸偶联的信息。我们假设 CPC 算法衍生的指标将与儿科人群中基于鼻压的呼吸暂停低通气评分相关。
共分析了 63 名受试者（平均年龄 6.2 岁；范围 2-12 岁），通过 CPC 和传统的鼻流量和脱饱和度评分进行分析，这些评分是在心肺记录期间获得的。计算了 CPC 指数的特征及其与传统 SDB 评分的相关性。
高频耦合（HFC）是 CPC 稳定睡眠状态的标志物，其比例随着 SDB 而降低。HFC 持续时间与鼻流量衍生的呼吸干扰指数（RDI），CPC 衍生的 RDI（CPC-RDI）和 3%氧减饱和指数呈负相关（相关系数分别为-0.60、-0.78 和-0.54）。CPC-RDI 与传统鼻流量 RDI 呈强正相关（相关系数 0.70）。在这个平均鼻流量 RDI 为 36.1/h 的组中，CPC 的总正确诊断百分比为 85.7%，非严重组（10 例，RDI <20/h）为 40%，严重组（53 例，RDI >20/h）为 94.3%。
心电图衍生的睡眠频谱指标与儿科 SDB 中的鼻流量衍生的呼吸异常相关。在合适的临床环境中，这种方法可能具有筛查效用，并可能允许跟踪治疗效果，特别是在严重 SDB 的儿童中。
