Weinreich Gerhard, Terjung Sarah, Wang Yi, Werther Stefanie, Zaffaroni Alberto, Teschler Helmut
Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University-Duisburg Essen, Essen, Germany.
Faculty of Physics, Technical University Dortmund, Dortmund, Germany.
Sleep Breath. 2018 Mar;22(1):131-138. doi: 10.1007/s11325-017-1546-x. Epub 2017 Aug 18.
Recent studies found that the non-contact screening device SleepMinder (ResMed Sensor Technologies, Dublin, Ireland) detects sleep-disordered breathing (SDB) with high diagnostic accuracy in cohorts suspected of this disorder. However, it was reported that in patients with periodic limb movement in sleep (PLMS), this non-contact device overestimates the apnea-hypopnea index (AHI). We aimed to overcome this limitation by introducing the novel sleep disorder index (SDI) which is sum of the AHI and the period limb movement index (PLMI).
Between January 2011 and December 2013, we studied a mixed cohort of 57 patients (31 OSA, 19 PLMS). The easy-to-use non-contact device emits a very weak electromagnetic radiation and detects body movement by measuring the Doppler effect. We interpreted the device-generated movement index as the SDI and validated the diagnostic accuracy against simultaneous application of the gold-standard polysomnography (PSG).
We found that the SDI of the non-contact device correlated well with the sum of AHI and PLMI derived from PSG (r = 0.79, p = 0.01). For PSG-derived SDI cutoff ≥ 15/h, we obtained a sensitivity of 92.2% and a specificity of 95.8%. Positive likelihood ratio was 23.3 and negative likelihood ratio 0.03.
The studied non-contact screening device detects accurately the combination of the sleep disorders SDB and/or PLM. However, further testing is required in order to specify the nature of the underlying sleep disorder. At the current stage of algorithm development, the clinical strength is that the studied non-contact device can be used as a rule-out screening device for SDB and PLM.
近期研究发现，非接触式筛查设备SleepMinder（瑞思迈传感技术公司，爱尔兰都柏林）在疑似患有睡眠呼吸障碍（SDB）的队列中检测睡眠呼吸障碍时具有较高的诊断准确性。然而，有报道称，在患有睡眠期周期性肢体运动（PLMS）的患者中，这种非接触式设备会高估呼吸暂停低通气指数（AHI）。我们旨在通过引入新的睡眠障碍指数（SDI）来克服这一局限性，该指数是AHI与周期性肢体运动指数（PLMI）之和。
在2011年1月至2013年12月期间，我们研究了一个由57名患者组成的混合队列（31例阻塞性睡眠呼吸暂停，19例PLMS）。这种易于使用的非接触式设备会发出非常微弱的电磁辐射，并通过测量多普勒效应来检测身体运动。我们将设备生成的运动指数解释为SDI，并与同时应用的金标准多导睡眠图（PSG）进行对比，以验证诊断准确性。
我们发现非接触式设备的SDI与PSG得出的AHI和PLMI之和具有良好的相关性（r = 0.79，p = 0.01）。对于PSG得出的SDI临界值≥15次/小时，我们获得了92.2%的灵敏度和95.8%的特异性。阳性似然比为23.3，阴性似然比为0.03。
所研究的非接触式筛查设备能够准确检测睡眠障碍SDB和/或PLM的组合。然而，为了明确潜在睡眠障碍的性质，还需要进一步测试。在算法开发的现阶段，该研究非接触式设备的临床优势在于可作为SDB和PLM的排除筛查设备。
