Tsukahara Masanori, Sakao Seiichiro, Jujo Takayuki, Sakurai Takayuki, Terada Jiro, Kunii Reiko, Tanabe Nobuhiro, Tatsumi Koichiro
Department of Respirology (B2), Graduate School of Medicine, Chiba University, Japan.
Intern Med. 2014;53(12):1307-13. doi: 10.2169/internalmedicine.53.2208. Epub 2014 Jun 15.
Laboratory-based polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea-hypopnea syndrome (OSAHS), but it is expensive and requires overnight hospitalization. Recently, a sheet-shaped breath detection monitor, the SD-101, has been developed, and several reports have so far demonstrated the screening accuracy of this device. The aim of this study was to assess the accuracy and the uncertainty of this device.
A total of 101 suspected OSAHS patients underwent simultaneous examinations with PSG and the SD-101.
There was a statistically significant relationship between the respiratory disturbance index (RDI) by the SD-101 and the apnea-hypopnea index (AHI) by PSG. At an RDI cutoff of 14 episodes per hour, the sensitivity and specificity to detect an AHI ≥20 episodes per hour were 90.2% and 90.0%, respectively. To reduce the influence of sleep efficiency, the time in bed (TIB) obtained from PSG, instead of the total seep time (TST), was used to calculate the AHI from the PSG data. There was also a statistically significant relationship between the RDI and AHI for the TIB. Moreover, it was suggested that arousal index and TIB were likely associated with false-negative and/or false-positive results.
Although the present study demonstrated a close relationship between the RDI and the AHI, use of the SD-101 to examine symptomatic OSAHS patients should be performed with a full understanding of its incapability to detect the sleep state, including arousal reaction and the existence of false respiratory events caused by body movements.
基于实验室的多导睡眠图(PSG)是诊断阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的金标准,但它费用高昂且需要过夜住院。最近,一种片状呼吸检测监测仪SD - 101已被研发出来,到目前为止已有多篇报告证明了该设备的筛查准确性。本研究的目的是评估该设备的准确性和不确定性。
共有101例疑似OSAHS患者同时接受了PSG和SD - 101检查。
SD - 101得出的呼吸紊乱指数(RDI)与PSG得出的呼吸暂停低通气指数(AHI)之间存在统计学上的显著关系。当RDI截断值为每小时14次发作时,检测AHI≥每小时20次发作的敏感性和特异性分别为90.2%和90.0%。为了减少睡眠效率的影响,从PSG获得的卧床时间(TIB)而非总睡眠时间(TST)被用于根据PSG数据计算AHI。TIB的RDI与AHI之间也存在统计学上的显著关系。此外,提示觉醒指数和TIB可能与假阴性和/或假阳性结果相关。
尽管本研究证明了RDI与AHI之间存在密切关系,但在对有症状的OSAHS患者使用SD - 101进行检查时,应充分了解其无法检测睡眠状态的情况,包括觉醒反应以及身体运动引起的假呼吸事件的存在。