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动脉僵硬度对阻塞性睡眠呼吸暂停患者 WatchPAT 变量的影响。

Impact of Arterial Stiffness on WatchPAT Variables in Patients With Obstructive Sleep Apnea.

机构信息

Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Department of Global Clinical Research, Graduate School of Medicine, Chiba University, Chiba, Japan.

出版信息

J Clin Sleep Med. 2018 Mar 15;14(3):319-325. doi: 10.5664/jcsm.6970.

Abstract

STUDY OBJECTIVES

The WatchPAT is a wrist-worn portable device that creates integration data regarding peripheral arterial tone (PAT), oxyhemoglobin saturation, heart rate, and actigraphy to diagnose or screen for obstructive sleep apnea (OSA). Previous studies have demonstrated the efficacy and validity of respiratory variables measured by the WatchPAT compared to those using polysomnography (PSG). However, the effects of arterial stiffness or atherosclerosis on WatchPAT parameters remain to be elucidated.

METHODS

Sixty-one consecutive patients with suspected OSA who underwent home-based testing with the WatchPAT 200, standard in-laboratory overnight polysomnography (PSG), and pulse wave velocity (PWV) as an index of arterial stiffness were studied. All PSG recordings were scored manually using the American Academy of Sleep Medicine criteria, whereas WatchPAT data were analyzed by an automatic algorithm. We evaluated how arterial stiffness affected respiratory event index data in WatchPAT (WP-AHI), because WP-AHI could be partly influenced by PAT, comparing WP-AHI and the apneahypopnea index measured by PSG (PSG-AHI) in consideration of PWV result.

RESULTS

Overall, WP-AHI was moderately correlated to PSG-AHI, but WP-AHI was significantly lower than PSG-AHI (28.4 ± 19.2 versus 53.6 ± 30.2 events/h, < .0001). For the lower PWV group, there was a significant correlation and good agreement between the WP-AHI and PSG-AHI, but as the PWV increased, there was low correlation between the WP-AHI and PSG-AHI.

CONCLUSIONS

Arterial stiffness may affect the respiratory variables measured by WatchPAT in patients with OSA.

COMMENTARY

A commentary on this article appears in this issue on page 301.

摘要

研究目的

WatchPAT 是一种可佩戴在手腕上的便携式设备,可生成有关周围动脉张力(PAT)、氧合血红蛋白饱和度、心率和运动活动的综合数据,用于诊断或筛查阻塞性睡眠呼吸暂停(OSA)。先前的研究已经证明了 WatchPAT 测量的呼吸变量与多导睡眠图(PSG)相比的有效性和有效性。然而,动脉僵硬或动脉粥样硬化对 WatchPAT 参数的影响仍有待阐明。

方法

研究了 61 例连续疑似 OSA 患者,他们接受了基于家庭的 WatchPAT 200 测试、标准的实验室整夜多导睡眠图(PSG)和脉搏波速度(PWV)作为动脉僵硬的指标。所有 PSG 记录均使用美国睡眠医学学会标准进行手动评分,而 WatchPAT 数据则由自动算法进行分析。我们评估了动脉僵硬如何影响 WatchPAT 中的呼吸事件指数数据(WP-AHI),因为 WP-AHI 可能会受到 PAT 的部分影响,因此考虑到 PWV 结果,比较了 WP-AHI 和 PSG 测量的呼吸暂停低通气指数(PSG-AHI)。

结果

总体而言,WP-AHI 与 PSG-AHI 中度相关,但 WP-AHI 明显低于 PSG-AHI(28.4±19.2 与 53.6±30.2 事件/小时, <.0001)。对于较低的 PWV 组,WP-AHI 与 PSG-AHI 之间存在显著相关性和良好一致性,但随着 PWV 的增加,WP-AHI 与 PSG-AHI 之间的相关性较低。

结论

动脉僵硬可能会影响 OSA 患者 WatchPAT 测量的呼吸变量。

评论

本文的一篇评论文章见本期第 301 页。

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