Gyulay S, Gould D, Sawyer B, Pond D, Mant A, Saunders N
Sleep. 1987 Apr;10(2):130-42. doi: 10.1093/sleep/10.2.130.
Study of the epidemiology of disturbances of breathing during sleep was hampered until recently by the need to conduct studies in the laboratory, with attendant inconvenience and limited sample sizes. We assessed the accuracy of a microprocessor-based portable monitoring system (Vitalog PMS-8, Vitalog Corp., CA) to detect and classify episodes of disturbed breathing during sleep in 14 patients with sleep apnea by simultaneously recording oxygenation and thoracoabdominal motion on the portable system and a polygraph. Each patient slept in the laboratory for 1 night. In two subjects, the portable system failed to record thoracoabdominal signals. In the remaining subjects, the portable system detected 78% of 2,340 episodes of disturbed breathing, but the recorded information was not sufficient to allow confident classification into central or obstructive events. The positive predictive value of disturbed breathing detected by the portable system was 64%, Respiratory disturbance indices (RDI) computed from the polygraph and portable records were correlated (r = 0.70; p less than 0.01), and all patients with sleep apnea were correctly diagnosed by the portable system. The portable system overestimated arterial oxygen saturation (SaO2) recorded by an ear oximeter (Biox IIA, Ohmeda, CO) but the error was less than 10% of the true value at SaO2 greater than 60%. Seven normal subjects were studied while awake to examine the accuracy of volume measurements made by the portable system and the system's ability to detect paradoxical thoracoabdominal motion of various degrees. Absolute measurement of tidal volume was inaccurate, but detection rate of paradoxical thoracoabdominal motion was excellent (97%). We conclude that the portable system is sufficiently sensitive to allow detection of patients with breathing disorders during sleep, but further developments are necessary before the system can be relied on for accurate classification of apneas and hypoventilation.
直到最近，睡眠期间呼吸障碍的流行病学研究一直受到阻碍，因为需要在实验室进行研究，这带来了不便且样本量有限。我们评估了一种基于微处理器的便携式监测系统（Vitalog PMS - 8，Vitalog公司，加利福尼亚州）在14例睡眠呼吸暂停患者中检测和分类睡眠期间呼吸障碍发作的准确性，通过在便携式系统和多导睡眠图上同时记录氧合和胸腹运动。每位患者在实验室睡一晚。在两名受试者中，便携式系统未能记录胸腹信号。在其余受试者中，便携式系统检测到了2340次呼吸障碍发作中的78%，但记录的信息不足以可靠地分类为中枢性或阻塞性事件。便携式系统检测到的呼吸障碍的阳性预测值为64%，根据多导睡眠图和便携式记录计算的呼吸紊乱指数（RDI）具有相关性（r = 0.70；p < 0.01），并且便携式系统正确诊断了所有睡眠呼吸暂停患者。便携式系统高估了经耳脉搏血氧仪（Biox IIA，Ohmeda公司，科罗拉多州）记录的动脉血氧饱和度（SaO2），但在SaO2大于60%时，误差小于真实值的10%。对7名正常受试者在清醒状态下进行了研究，以检查便携式系统进行容量测量的准确性以及该系统检测不同程度矛盾胸腹运动的能力。潮气量的绝对测量不准确，但矛盾胸腹运动的检测率很高（97%）。我们得出结论，便携式系统足够敏感，能够检测出睡眠期间有呼吸障碍的患者，但在该系统能够可靠地用于准确分类呼吸暂停和通气不足之前，还需要进一步改进。
