ECG-derived estimators of sleep physiology

基于心电图的睡眠生理学估计器

• 批准号: 7061681
• 负责人: Robert Joseph Thomas
• 金额: $ 14.58万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-05 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7061681
• 关键词: REM sleep; adult human (21+); bioimaging /biomedical imaging; biomarker; biomedical automation; child (0-11); data collection methodology /evaluation; diagnosis design /evaluation; diagnosis quality /standard; electrocardiography; human data; neuropsychology; patient /disease registry; physiologic stressor; polysomnography; respiratory airflow disorder; respiratory disorder diagnosis; sleep apnea; sleep disorders; statistics /biometry

DESCRIPTION (PROVIDED BY APPLICANT): Polysomnograms are labor-intensive, expensive and impractical to perform repeatedly to assess therapeutic efficacy. Typical measures of sleep disordered breathing (SDB) severity include event counts, such as the apnea-hypopnea index, that utilize physiologically arbitrary scoring criteria. These measures correlate only modestly with neurobehavioral and cardiovascular outcomes in adults and children. Standard sleep stage scoring differentiates REM and NREM sleep types and NREM depth, but provides little information about physiological stability. Thus, there is a need for a simple, inexpensive and easily repeatable measure of the presence and impact of SDB on sleep state physiology and stability. The investigators have developed a fully automated surface electrocardiogram (ECG)-derived sleep physiology estimator, based on the quantitative analysis of cardiopulmonary coupling from a single-lead ECG. This approach combines the use of mechanical and autonomic effects of physiologic vs. periodic breathing on ECG parameters related to heart rate variability and QRS electrical axis. Physiologically unstable sleep associated with SDB manifests the EEG morphology of cyclic alternating pattern (CAP), regardless of conventional stage scoring. In contrast, periods of non-CAP represent physiologically stable sleep behavior. We have found that the coupling estimator shows a strong correlation with CAP and non- CAP states, thus providing a promising new biomarker of sleep physiology and pathology based on the percentage of sleep spent in periods of unstable sleep behavior. The goals of the proposed research are to: 1) Refine the technique using a sleep laboratory database. 2) Test it, using established databases, as a SDE detector in community-dwelling adults (Sleep Heart Health Study, SHHS) and children (Neurobehavioral Assessment and Pediatric Sleep, NAPS). 3) To correlate the biomarker with excessive daytime sleepiness, subjective sleep quality and cardiovascular morbidity (SHHS), and reduced neurocognitive function (NAPS).

描述（由申请人提供）：多导睡眠图是劳动密集型的、昂贵的且不切实际的重复执行来评估治疗效果。睡眠呼吸障碍 (SDB) 严重程度的典型衡量标准包括事件计数，例如呼吸暂停-呼吸不足指数，该指数采用生理学任意评分标准。这些指标与成人和儿童的神经行为和心血管结局只有适度的相关性。标准睡眠阶段评分区分了 REM 和 NREM 睡眠类型以及 NREM 深度，但提供的有关生理稳定性的信息很少。因此，需要一种简单、廉价且易于重复的测量方法来测量 SDB 的存在及其对睡眠状态生理学和稳定性的影响。研究人员基于对单导联心电图心肺耦合的定量分析，开发了一种全自动表面心电图 (ECG) 衍生的睡眠生理学估计器。该方法结合了生理呼吸与周期性呼吸对与心率变异性和 QRS 电轴相关的 ECG 参数的机械和自主效应的使用。与 SDB 相关的生理不稳定睡眠表现为循环交替模式 (CAP) 的脑电图形态，无论常规阶段评分如何。相反，非 CAP 时期代表生理上稳定的睡眠行为。我们发现耦合估计量显示出与 CAP 和非 CAP 状态的强相关性，从而根据不稳定睡眠行为期间所花费的睡眠百分比，提供了一种有前景的睡眠生理学和病理学新生物标志物。拟议研究的目标是：1）使用睡眠实验室数据库完善技术。 2) 使用已建立的数据库，将其作为 SDE 检测器在社区居住的成人（睡眠心脏健康研究，SHHS）和儿童（神经行为评估和儿童睡眠，NAPS）中进行测试。 3) 将生物标志物与白天过度嗜睡、主观睡眠质量和心血管发病率 (SHHS) 以及神经认知功能下降 (NAPS) 相关联。

项目成果

Differentiating obstructive from central and complex sleep apnea using an automated electrocardiogram-based method.

• DOI: 10.1093/sleep/30.12.1756
• 发表时间: 2007-12
• 期刊: Sleep
• 影响因子: 5.6
• 作者: R. Thomas;J. Mietus;Chung-Kang Peng;G. Gilmartin;Robert W Daly;A. Goldberger;D. Gottlieb

Obstructive sleep apnea alters sleep stage transition dynamics.

• DOI: 10.1371/journal.pone.0011356
• 发表时间: 2010-06-28
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Bianchi MT;Cash SS;Mietus J;Peng CK;Thomas R
• 通讯作者: Thomas R

Mapping sleep using coupled biological oscillations.

使用耦合生物振荡绘制睡眠图。

• DOI: 10.1109/iembs.2011.6090361
• 发表时间: 2011
• 期刊: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
• 作者: Thomas,RobertJoseph;Mietus,JosephE
• 通讯作者: Mietus,JosephE

Alternative approaches to treatment of Central Sleep Apnea.

• DOI: 10.1016/j.jsmc.2013.10.008
• 发表时间: 2014-03-01
• 期刊: SLEEP MEDICINE CLINICS
• 影响因子: 2.8
• 作者: Thomas, Robert Joseph

Prevalent hypertension and stroke in the Sleep Heart Health Study: association with an ECG-derived spectrographic marker of cardiopulmonary coupling.

睡眠心脏健康研究中普遍存在的高血压和中风：与心肺耦合的心电图衍生光谱标记物的关联。

• 发表时间: 2009
• 期刊: Sleep
• 影响因子: 5.6
• 作者: Thomas,RobertJoseph;Weiss,MatthewD;Mietus,JosephE;Peng,Chung-Kang;Goldberger,AryL;Gottlieb,DanielJ
• 通讯作者: Gottlieb,DanielJ