Added value of a mandible movement automated analysis in the screening of obstructive sleep apnea
Added value of a mandible movement automated analysis in the screening of obstructive sleep apnea
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DOI：
10.1111/j.1365-2869.2012.01035.x
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发表时间：
2013-02-01
影响因子：
4.4
通讯作者：
Poirrier, Robert
中科院分区：
文献类型：
--
作者：
Maury, Gisele;Cambron, Laurent;Poirrier, Robert
实验室多导睡眠图是诊断阻塞性睡眠呼吸暂停综合征的金标准，但耗时且昂贵，许多睡眠实验室的等待名单很长。因此，对检测呼吸事件的替代方法的研究正在增长。在这项前瞻性研究中，我们比较了参加多导睡眠图与其他两种方法，有或没有下颌骨运动自动分析提供的测距仪，并添加到气流和氧饱和度分析检测呼吸事件。下颌骨运动自动分析允许检测显著的下颌骨运动，这是唤醒的替代。所有参数同时记录在570名连续患者（男/女：381/189;年龄：50 ± 14岁;体重指数：29 ± 7 kg m（-2））访问睡眠实验室。最常见的主要诊断是：阻塞性睡眠呼吸暂停（344; 60%）;失眠/焦虑/抑郁（75; 13%）;和上气道阻力综合征（25; 4%）。多导睡眠图与下颌运动自动分析法的相关性良好（r：0.95; P < 0.001）。该方法的准确性特征显示，随着下颌骨运动自动分析的增加，灵敏度和阴性预测值在统计学上有所改善。对于阻塞性睡眠严重程度的不同诊断阈值，这是正确的，对于中度至重度指数（呼吸暂停低通气指数=15 h（-1））具有极好的效率。布兰德和奥特曼的一个阴谋证实了这一分析。与气流和氧饱和度分析相比，增加下颌骨运动自动分析显著提高了呼吸指数计算的准确性。这是一种有吸引力的方法，用于阻塞性睡眠呼吸暂停综合征的筛查，由于突出的下颌运动作为觉醒的标记，增加了检测呼吸不足的能力。
In-laboratory polysomnography is the gold standard for diagnosing obstructive sleep apnea syndrome, but is time consuming and costly, with long waiting lists in many sleep laboratories. Therefore, the search for alternative methods to detect respiratory events is growing. In this prospective study, we compared attended polysomnography with two other methods, with or without mandible movement automated analysis provided by a distance-meter and added to airflow and oxygen saturation analysis for the detection of respiratory events. The mandible movement automated analysis allows for the detection of salient mandible movement, which is a surrogate for arousal. All parameters were recorded simultaneously in 570 consecutive patients (M/F: 381/189; age: 50 +/- 14 years; body mass index: 29 +/- 7 kg m(-2)) visiting a sleep laboratory. The most frequent main diagnoses were: obstructive sleep apnea (344; 60%); insomnia/anxiety/depression (75; 13%); and upper airway resistance syndrome (25; 4%). The correlation between polysomnography and the method with mandible movement automated analysis was excellent (r: 0.95; P < 0.001). Accuracy characteristics of the methods showed a statistical improvement in sensitivity and negative predictive value with the addition of mandible movement automated analysis. This was true for different diagnostic thresholds of obstructive sleep severity, with an excellent efficiency for moderate to severe index (apneahypopnea index =15 h(-1)). A Bland & Altman plot corroborated the analysis. The addition of mandible movement automated analysis significantly improves the respiratory index calculation accuracy compared with an airflow and oxygen saturation analysis. This is an attractive method for the screening of obstructive sleep apnea syndrome, increasing the ability to detect hypopnea thanks to the salient mandible movement as a marker of arousals.