LHL Hospital Gardermoen, Jessheim, Norway.
Haukeland university hospital, Bergen, Norway.
Sci Rep. 2019 Dec 18;9(1):19392. doi: 10.1038/s41598-019-55958-2.
Obstructive sleep apnea (OSA) worsens outcomes in Chronic Obstructive Pulmonary Disease (COPD), and reduced sleep quality is common in these patients. Thus, objective sleep monitoring is needed, but polysomnography (PSG) is cumbersome and costly. The WatchPAT determines sleep by a pre-programmed algorithm and has demonstrated moderate agreement with PSG in detecting sleep stages in normal subjects and in OSA patients. Here, we validated WatchPAT against PSG in COPD patients, hypothesizing agreement in line with previous OSA studies. 16 COPD patients (7 men, mean age 61 years), underwent simultaneous overnight recordings with PSG and WatchPAT. Accuracy in wake and sleep staging, and concordance regarding total sleep time (TST), sleep efficiency (SE), and apnea hypopnea index (AHI) was calculated. Compared to the best fit PSG score, WatchPAT obtained 93% sensitivity (WatchPAT = sleep when PSG = sleep), 52% specificity (WatchPAT = wake when PSG = wake), 86% positive and 71% negative predictive value, Cohen's Kappa (κ) = 0.496. Overall agreement between WatchPat and PSG in detecting all sleep stages was 63%, κ = 0.418. The mean(standard deviation) differences in TST, SE and AHI was 25(61) minutes (p = 0.119), 5(15) % (p = 0.166), and 1(5) (p = 0.536), respectively. We conclude that in COPD-patients, WatchPAT detects sleep stages in moderate to fair agreement with PSG, and AHI correlates well.
阻塞性睡眠呼吸暂停（OSA）会使慢性阻塞性肺疾病（COPD）患者的预后恶化，这些患者的睡眠质量通常会下降。因此，需要进行客观的睡眠监测，但多导睡眠图（PSG）既繁琐又昂贵。WatchPAT 通过预编程算法来确定睡眠，并且在检测正常受试者和 OSA 患者的睡眠阶段方面，已被证实与 PSG 具有中等一致性。在这里，我们假设在 COPD 患者中 WatchPAT 与 PSG 的一致性与之前的 OSA 研究一致，因此对其进行了验证。16 名 COPD 患者（7 名男性，平均年龄 61 岁）接受了 PSG 和 WatchPAT 的同时夜间记录。计算了清醒和睡眠分期的准确性，以及总睡眠时间（TST）、睡眠效率（SE）和呼吸暂停低通气指数（AHI）的一致性。与最佳拟合 PSG 评分相比，WatchPAT 的灵敏度为 93%（当 PSG=睡眠时，WatchPAT=睡眠），特异性为 52%（当 PSG=清醒时，WatchPAT=清醒），阳性预测值为 86%，阴性预测值为 71%，Cohen's Kappa（κ）为 0.496。WatchPat 和 PSG 在检测所有睡眠阶段方面的总体一致性为 63%，κ=0.418。TST、SE 和 AHI 的平均（标准差）差异分别为 25（61）分钟（p=0.119）、5（15）%（p=0.166）和 1（5）（p=0.536）。我们得出结论，在 COPD 患者中，WatchPAT 与 PSG 的睡眠分期检测具有中等至尚可的一致性，且 AHI 相关性良好。
