Svanborg E, Larsson H, Carlsson-Nordlander B, Pirskanen R
Department of Clinical Neurophysiology, Karolinska Institutet, Söder Hospital, Stockholm, Sweden.
Chest. 1990 Dec;98(6):1341-5. doi: 10.1378/chest.98.6.1341.
A simplified sleep apnea investigation consisting of combined oximetry and respiration movement monitoring was compared with conventional polysomnography. These two types of recordings were performed simultaneously during one night in 77 patients with suspected obstructive sleep apnea syndrome (OSAS). A static charge sensitive bed (SCSB) was used in the simplified recording because it provides a comfortable and reliable means of recording respiration movements. Periods of obstructive apneas gave a diamond-shaped periodic respiration movement pattern in the SCSB, usually accompanied by repetitive oxygen desaturations. The average number of desaturations greater than or equal to 4 percent per sleeping hour was termed the oxygen desaturation index (ODI) and compared with the apnea index (AI). In the whole population they were well correlated (p less than 0.0001, R2 = 0.41), but in individual cases there were considerable discrepancies. Patients with periodic respiration movements less than 18 percent of total sleeping time and ODI less than 2 never had AI greater than or equal to 5, whereas patients with periodic respiration greater than 45 percent and ODI greater than 6 always had AI greater than or equal to 5. Fifty-one of the 77 patients fulfilled these criteria. A bradycardia response to apneas was absent in 29 percent of patients with AI greater than or equal to 5. A combination of respiration movement and oximetry recording thus seems to give sufficient information to confirm or negate a diagnosis of OSAS in a majority of patients with clinical symptoms. In borderline patients, further investigations should be performed.
将一种由联合脉搏血氧饱和度测定和呼吸运动监测组成的简化睡眠呼吸暂停检查方法与传统多导睡眠图进行了比较。在77例疑似阻塞性睡眠呼吸暂停综合征（OSAS）的患者中，在一个晚上同时进行了这两种记录。简化记录中使用了静态电荷敏感床（SCSB），因为它提供了一种舒适且可靠的记录呼吸运动的方法。阻塞性呼吸暂停期间，SCSB中会出现菱形周期性呼吸运动模式，通常伴有重复性氧饱和度下降。每睡眠小时中大于或等于4%的氧饱和度下降的平均次数被称为氧饱和度下降指数（ODI），并与呼吸暂停指数（AI）进行比较。在总体人群中，它们具有良好的相关性（p<0.0001，R2 = 0.41），但在个别病例中存在相当大的差异。周期性呼吸运动时间占总睡眠时间不到18%且ODI小于2的患者，其AI从未大于或等于5，而周期性呼吸运动大于45%且ODI大于6的患者，其AI总是大于或等于5。77例患者中有51例符合这些标准。在AI大于或等于5的患者中，29%没有对呼吸暂停的心动过缓反应。因此，呼吸运动和脉搏血氧饱和度记录的组合似乎能提供足够的信息，以在大多数有临床症状的患者中证实或否定OSAS的诊断。对于临界患者，应进行进一步检查。
