INSERM, U1028, CNRS, UMR5292, Centre de Recherche en Neurosciences de Lyon, Intégration centrale de la douleur chez l’Homme, Université Claude Bernard, Lyon, F-69000, France.
Sleep. 2011 Aug 1;34(8):1051-9. doi: 10.5665/SLEEP.1160.
Pulse transit time (PPT) has been introduced as a useful screening tool to diagnose sleep disordered breathing (SDB). Since the prevalence of SDB increases with age, the question is whether PTT could be used to diagnose SDB in the elderly. We assess the effectiveness of PTT for SDB screening in a large healthy elderly population.
Community-based sample in home and research clinical settings.
N/A.
Seven hundred eighty volunteers, free of cardiac and neurologic disease, aged 68.6 ± 1.0 years, underwent ambulatory polygraphy to measure the apnea-hypopnea index (AHI). The presence of SDB was defined as an AHI of 15 or greater. The PTT was continuously monitored during the nocturnal study, and the overall autonomic arousal index (AAI) was calculated.
SDB was diagnosed in 447 (57.3%) subjects. In these subjects, the Bland-Altman plot for AAI revealed an underestimation with a bias of -8.04 ± 16.55 events per hour (mean ± 95% confidence interval). Receiver operating characteristic curves constructed for an AHI of 15 or greater defined an area under the curve of 0.67 and a cutoff point to AAI 32.3 events per hour, giving a sensitivity of 70.5% and a specificity of 54.7%. For prediction of an AHI of at least 30, the area under the curve was equal to 0.74 for a cutoff point of 56.3 events per hour, giving a better specificity (94.7%) but a lower sensitivity (32.2%).
In a healthy older population, the AAI showed moderate sensitivity for predicting SDB. This data does not allow us to use PTT as a screening tool for the diagnosis of SDB in the elderly.
NCT 00759304 and NCT 00766584.
脉搏传递时间（PTT）已被引入作为一种有用的筛查工具，用于诊断睡眠呼吸障碍（SDB）。由于 SDB 的患病率随年龄增长而增加，因此问题是 PTT 是否可用于诊断老年人的 SDB。我们评估了 PTT 在大型健康老年人群中筛查 SDB 的效果。
社区为基础的样本，包括家庭和研究临床环境。
无。
780 名志愿者，无心脏和神经疾病，年龄 68.6 ± 1.0 岁，接受动态多导睡眠图测量呼吸暂停低通气指数（AHI）。SDB 的存在定义为 AHI 大于等于 15。PTT 在夜间研究期间连续监测，并计算总体自主神经唤醒指数（AAI）。
447 名（57.3%）受试者被诊断为 SDB。在这些受试者中，AAI 的 Bland-Altman 图显示存在低估，偏倚为-8.04 ± 16.55 次/小时（平均值 ± 95%置信区间）。为 AHI 大于等于 15 构建的接收者操作特征曲线定义了曲线下面积为 0.67，AAI 为 32.3 次/小时的截断点，敏感性为 70.5%，特异性为 54.7%。对于预测 AHI 至少为 30，曲线下面积为 0.74，截断点为 56.3 次/小时，特异性更高（94.7%），但敏感性较低（32.2%）。
在健康的老年人群中，AAI 对预测 SDB 具有中等敏感性。这些数据不允许我们将 PTT 用作诊断老年人 SDB 的筛查工具。
NCT 00759304 和 NCT 00766584。
