Song X, Ge Y J, Kong X Y, Li X Y, Zhang P, Hu T, Zhang X X, Rao J X, Chen G H
Department of Neurology (Sleep Disorders), the Affiliated Chaohu Hospital of Anhui Medical University, the Sleep Medicine Institute, Anhui Medical University, Hefei 238000, China.
Zhonghua Yi Xue Za Zhi. 2020 Mar 24;100(11):817-822. doi: 10.3760/cma.j.cn112137-20190911-02008.
To compare diagnostic consistency for chronic insomnia (CI) and obstructive sleep apnea (OSA) between cardiopulmonary coupling (CPC) and polysomnographm (PSG). Two hundred and twenty-one patients were enrolled from the Department of Sleep Disorders, Chaohu Hospital affiliated to Anhui Medical University from July 2018 to December 2019, and monitored with overnight CPC and PSG simultaneously. According to clinical representations and PSG results, there were 88 males and 80 females with CI and OSA, including chronic insomnia (CI group, 93 cases), OSA (OSA group, 36 cases) and comorbid OSA with CI (COI group, 39 cases). The consistency of sleep and OSA parameters measured with CPC and PSG were analyzed. (1)For all patients and CI group, the total sleep time (TST), sleep efficiency (SE) and rapid eye movement (REM) sleep time measured by CPC were significantly higher than those measured with PSG, and the wake time after sleep onset (WASO) was significantly lower than that measured with PSG (the specific median comparisons were as follows 420.0 min vs 395.5 min, 93.7% vs 81.8%, 90.0 min vs 37.5 min, 18.0 min vs 63.0 min in CI group, respectively; 414.0 min vs 392.5 min, 91.9% vs 81.9%, 72.0 min vs 34.8 min, 24.0 min vs 58.4 min in all patients, respectively (all ≤0.001). However, in the OSA patients, the TST, SE, WASO, REM sleep time and NREM sleep time measured using two methods were similar (all 0.05). (2) According to OSA criteria, the consistency between CPC and PSG was fair (=0.255). Only CPC has a certain degree of value for OSA screening when the AHI ≥ 20/h (=0.580, sensitivity: 0.85, specificity: 0.82, positive predictive value: 0.59, negative predictive value: 0.95, positive likelihood ratio: 4.72). CPC technology may overestimate the sleep quality of CI patients, and its consistency is fair compared with that of PSG in the diagnosis of OSA.
比较心肺耦合（CPC）与多导睡眠图（PSG）对慢性失眠（CI）和阻塞性睡眠呼吸暂停（OSA）的诊断一致性。2018年7月至2019年12月，从安徽医科大学附属巢湖医院睡眠障碍科招募了221例患者，同时采用夜间CPC和PSG进行监测。根据临床表现和PSG结果，有88例男性和80例女性患有CI和OSA，包括慢性失眠（CI组，93例）、OSA（OSA组，36例）和CI合并OSA（COI组，39例）。分析了用CPC和PSG测量的睡眠和OSA参数的一致性。（1）对于所有患者和CI组，CPC测量的总睡眠时间（TST）、睡眠效率（SE）和快速眼动（REM）睡眠时间显著高于PSG测量的结果，睡眠开始后觉醒时间（WASO）显著低于PSG测量的结果（CI组具体中位数比较如下：分别为420.0分钟对395.5分钟、93.7%对81.8%、90.0分钟对37.5分钟、18.0分钟对63.0分钟；所有患者分别为414.0分钟对392.5分钟、91.9%对81.9%、72.0分钟对34.8分钟、24.0分钟对58.4分钟（均≤0.001）。然而，在OSA患者中，两种方法测量的TST、SE、WASO、REM睡眠时间和非快速眼动睡眠时间相似（均P>0.05）。（2）根据OSA标准，CPC与PSG之间的一致性为中等（κ=0.255）。当呼吸暂停低通气指数（AHI）≥20次/小时时，仅CPC对OSA筛查有一定价值（κ=0.580，敏感性：0.85，特异性：0.82，阳性预测值：0.59，阴性预测值：0.95，阳性似然比：4.72）。CPC技术可能高估了CI患者的睡眠质量，其在OSA诊断中与PSG相比一致性为中等。
