Research and Development at CIDELEC, Sainte Gemmes, France.
Interdisciplinary Sleep Medicine Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Sleep Breath. 2019 Dec;23(4):1169-1176. doi: 10.1007/s11325-019-01793-8. Epub 2019 Feb 7.
To determine if recording of suprasternal pressure (SSP) can classify apneas and hypopneas as reliably as respiratory inductance plethysmography (RIP) belts and to compare the two methods to classification with esophageal pressure (Pes), the reference method for assessing respiratory effort.
In addition to polysomnographic recordings that included Pes, SSP was recorded. Recordings from 32 patients (25 males, mean age 66.7 ± 15.3 years, and mean BMI 30.1 ± 4.5 kg/m) were used to compare the classification of detected apneas and hypopneas by three methods of respiratory effort evaluation (Pes, RIP belts, and SSP). Signals were analyzed randomly and independently from each other. All recordings were analyzed according to AASM guidelines.
Using Pes as a reference for apnea characterization, the Cohen kappa (κ) was 0.93 for SSP and 0.87 for the RIP. The sensitivity/specificity of SSP was 97.0%/96.9% for obstructive, 93.9%/98.3% for central, and 94.9%/97.9% for mixed apneas. The sensitivity/specificity of the RIP was 97.4%/91.9% for obstructive, 87.5%/97.9% for central, and 85.6%/96.6% for mixed apneas. For hypopnea characterization using the Pes as a reference, κ was 0.92 for SSP and 0.86 for the RIP. The sensitivity/specificity of SSP was 99.7%/97.6% for obstructive and 97.6%/99.7% for central. The sensitivity/specificity of the RIP was 99.8%/81.1% for obstructive and 81.1%/99.8% for central.
These results confirm the excellent agreement in the detection of respiratory effort between SSP, RIP belts, and Pes signals. Thus, we conclude that apnea and hypopnea characterization in adults with SSP is a reliable method.
确定记录胸骨上压力（SSP）是否能像呼吸感应体积描记法（RIP）带一样可靠地对呼吸暂停和低通气进行分类，并将这两种方法与评估呼吸努力的参考方法食管压力（Pes）进行比较。
除了包括 Pes 的多导睡眠图记录外，还记录了 SSP。使用 32 名患者（25 名男性，平均年龄 66.7±15.3 岁，平均 BMI 30.1±4.5 kg/m）的记录来比较三种呼吸努力评估方法（Pes、RIP 带和 SSP）对检测到的呼吸暂停和低通气的分类。信号是随机和独立彼此分析的。所有记录均根据 AASM 指南进行分析。
使用 Pes 作为呼吸暂停特征的参考，SSP 的 Cohen kappa（κ）为 0.93，RIP 为 0.87。SSP 的敏感性/特异性分别为阻塞性 97.0%/96.9%、中枢性 93.9%/98.3%和混合性 94.9%/97.9%。RIP 的敏感性/特异性分别为阻塞性 97.4%/91.9%、中枢性 87.5%/97.9%和混合性 85.6%/96.6%。使用 Pes 作为参考，对低通气特征进行分类时，SSP 的 κ 值为 0.92，RIP 的 κ 值为 0.86。SSP 的敏感性/特异性分别为阻塞性 99.7%/97.6%和中枢性 97.6%/99.7%。RIP 的敏感性/特异性分别为阻塞性 99.8%/81.1%和中枢性 81.1%/99.8%。
这些结果证实了 SSP、RIP 带和 Pes 信号在检测呼吸努力方面的出色一致性。因此，我们得出结论，使用 SSP 对成年人进行呼吸暂停和低通气特征分析是一种可靠的方法。
