Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital Baselland, Liestal, Switzerland.
J Clin Sleep Med. 2022 Sep 1;18(9):2197-2205. doi: 10.5664/jcsm.10082.
To determine whether home sleep apnea testing with peripheral arterial tonometry (HSAT-PAT) can be used in upper airway stimulation to evaluate therapy success.
Data analysis from 50 consecutive patients receiving upper airway stimulation was performed. Baseline values were measured by polysomnography and HSAT-PAT. Follow-up was performed during and after titration (3-6 months) by polysomnography and HSAT-PAT and after 1 year by HSAT-PAT only. Primary outcome measures were reduction in the apnea-hypopnea index and oxygen desaturation index. In addition, an analysis of night-to-night variability for HSAT-PAT was performed.
All 50 patients completed their posttitration visit (3-6 months) and 41 patients completed the 1-year follow-up. In HSAT-PAT after 1 year, the mean apnea-hypopnea index (desaturation 3%) was reduced from 29.5 ± 17.1 events/h to 19.9 ± 13.1 events/h ( < .01) and the oxygen desaturation index (desaturation 4%) was reduced from 17.8 ± 12.6 events/h to 10.2 ± 8.3 events/h ( < .01). Therapy adherence after 1 year was high (6.6 ± 1.9 hours per night) and led to improvement in daytime sleepiness, meaning a reduction in the Epworth Sleepiness Scale score from 12.8 ± 5.4 to 5.9 ± 4.0 ( < .01). Analysis of night-to-night variability showed similar apnea-hypopnea index values between the 2 nights.
Upper airway stimulation was able to reduce the apnea-hypopnea index and oxygen desaturation index after 1 year, as assessed by full-night efficacy studies with HSAT-PAT. In addition, improvements in self-reported outcome parameters were observed. The importance of publishing the scoring criteria is highlighted and whether data are based on full-night efficacy studies or a selected period of time from a sleep study. This is a prerequisite for comparing data with other trials in the emerging field of upper airway stimulation.
Hinder D, Schams SC, Knaus C, Tschopp K. Home sleep apnea testing with peripheral arterial tonometry to assess outcome in upper airway stimulation. 2022;18(9):2197-2205.
确定家庭睡眠呼吸暂停测试（HSAT-PAT）结合外周动脉张力测定（peripheral arterial tonometry）能否用于上气道刺激评估治疗效果。
对 50 例连续接受上气道刺激治疗的患者进行数据分析。多导睡眠图和 HSAT-PAT 用于测量基线值。通过多导睡眠图和 HSAT-PAT 在滴定期间和之后（3-6 个月）以及 1 年后（仅通过 HSAT-PAT）进行随访。主要结局指标是呼吸暂停低通气指数（apnea-hypopnea index）和氧减指数（oxygen desaturation index）的降低。此外，还对 HSAT-PAT 的夜间变异性进行了分析。
所有 50 例患者均完成了滴定后（3-6 个月）的随访，41 例患者完成了 1 年的随访。在 1 年后的 HSAT-PAT 中，呼吸暂停低通气指数（desaturation 3%）从 29.5 ± 17.1 次/小时降至 19.9 ± 13.1 次/小时（<.01），氧减指数（desaturation 4%）从 17.8 ± 12.6 次/小时降至 10.2 ± 8.3 次/小时（<.01）。1 年后的治疗依从性较高（平均每晚 6.6 ± 1.9 小时），并改善了白天嗜睡症状，即 Epworth 嗜睡量表评分从 12.8 ± 5.4 分降至 5.9 ± 4.0 分（<.01）。夜间变异性分析显示，2 个夜间的呼吸暂停低通气指数值相似。
上气道刺激治疗 1 年后，通过 HSAT-PAT 进行的整夜疗效研究可降低呼吸暂停低通气指数和氧减指数。此外，还观察到自我报告的结果参数的改善。强调了公布评分标准的重要性，并指出数据是基于整夜疗效研究还是睡眠研究的特定时间段。这是将数据与上气道刺激领域新兴领域的其他试验进行比较的前提。
Hinder D, Schams SC, Knaus C, Tschopp K. 应用外周动脉张力测定的家庭睡眠呼吸暂停测试评估上气道刺激治疗的疗效。2022;18(9):2197-2205.
