Sleep Laboratory, Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
J Clin Sleep Med. 2011 Jun 15;7(3):301-6. doi: 10.5664/JCSM.1078.
One of the most important caveats of ambulatory devices is the inability to record and stage sleep. We assessed an algorithm determining 4 different stages: wake, light sleep, deep sleep, and REM sleep using signals derived from the portable monitor Watch-PAT100 (PAT recorder).
Participants (38 normal subjects and 189 patients with obstructive sleep apnea [OSA]) underwent simultaneous overnight recordings with polysomnography (PSG) and the PAT recorder in a study originally designed to assess the accuracy of the PAT recorder in diagnosing OSA. Light/deep sleep and REM sleep from the PAT recorder recording were automatically scored based on features extracted from time series of peripheral arterial tone amplitudes and inter pulse periods. The PSG scored sleep stages 1 and 2 were classified as light sleep for epoch-by-epoch comparisons.
The overall agreement in detecting light/deep and REM sleep were 88.6% ± 5.9% and 88.7% ± 5.5%, respectively. There was a good agreement between PSG and the PAT recorder in quantifying sleep efficiency (78.4% ± 9.9% vs. 78.8% ± 13.4%), REM latency (237 ± 148 vs. 225 ± 159 epochs), and REM percentage (14.4% ± 6.5% vs. 19.3% ± 8.7%). OSA severity did not affect the sensitivity and specificity of the algorithm. The Cohen κ coefficient for detecting all sleep stages: sleep from wake, REM from NREM sleep, and deep from light sleep were 0.48, 0.55, 0.59, and 0.46, respectively.
Analysis of autonomic signals from the PAT recorder can detect sleep stages with moderate agreement to more standard techniques in normal subjects and OSA patients. This novel algorithm may provide insights on sleep and sleep architecture when applying the PAT recorder for OSA diagnosis.
动态设备最重要的一个警告是无法记录和分期睡眠。我们评估了一种使用便携式监测仪 Watch-PAT100（PAT 记录器）获取的信号确定 4 个不同阶段的算法：清醒、浅睡、深睡和 REM 睡眠。
参与者（38 名正常受试者和 189 名阻塞性睡眠呼吸暂停[OSA]患者）在一项旨在评估 PAT 记录器诊断 OSA 准确性的研究中，同时进行了过夜多导睡眠图（PSG）和 PAT 记录器记录。根据从外周动脉张力幅度和脉搏间期时间序列中提取的特征，自动对 PAT 记录器记录的浅/深睡眠和 REM 睡眠进行评分。为了进行逐时比较，PSG 评分的睡眠阶段 1 和 2 被归类为浅睡眠。
检测浅/深睡眠和 REM 睡眠的总符合率分别为 88.6%±5.9%和 88.7%±5.5%。PSG 和 PAT 记录器在量化睡眠效率（78.4%±9.9%与 78.8%±13.4%）、快速眼动潜伏期（237±148 与 225±159 个时相）和快速眼动百分比（14.4%±6.5%与 19.3%±8.7%）方面具有良好的一致性。OSA 严重程度并不影响算法的敏感性和特异性。检测所有睡眠阶段的 Cohen κ 系数：从清醒到 REM 睡眠、从 NREM 睡眠到 REM 睡眠和从浅睡到深睡的睡眠分别为 0.48、0.55、0.59 和 0.46。
分析 PAT 记录器的自主信号可以在正常受试者和 OSA 患者中以中等程度的一致性检测睡眠阶段，这一技术比更标准的技术更为先进。这种新算法可能为应用 PAT 记录器诊断 OSA 时的睡眠和睡眠结构提供新的见解。
