Ambulatory Sleepiness & Apnea Propensity Evaluation Syst

描述：该项目的总体目标是开发一种新的动态、易于管理、持续时间短、高度定量的方法来评估/筛查个体的过度嗜睡，以及他/她发展为睡眠呼吸障碍（即睡眠呼吸暂停/睡眠呼吸不足）的倾向。拟议的动态嗜睡和呼吸暂停倾向（ASAP(tm)）评估系统是对影响数百万人的睡眠呼吸障碍和过度嗜睡存在的整个筛查/评估方法的范式改变（仅阻塞性睡眠呼吸暂停，OSA的患病率约为4%）。这是一种创新的方法，同时产生与(1)白天过度嗜睡和(2)睡眠期间出现呼吸障碍的可能性相关的两个指数。通过结合在短时间内（大约15分钟）获得的高度定量的警惕性维持测试（MAT）与在短时间内（大约30分钟）小睡后的觉醒到睡眠转变（包括神经和呼吸信号）的新分析。因此，MAT提供的“警惕性指数”与从随后的午睡中获得的“嗜睡指数”相结合，产生一个整体的“白天过度嗜睡指数”。通过对睡眠开始时呼吸变异性的一种新颖的自动分析，午睡还会产生一个整体的“呼吸暂停倾向指数”。申请人对不同OSA严重程度（正常、轻度、中度和重度）患者的PSG数据进行了初步分析，结果表明，在第一次清醒-睡眠转换前后计算的呼吸暂停倾向指数（Apnea-Propensity Index）具有良好的相关性（correlation Coef）。=86%)与OSA严重程度的临床指标（呼吸暂停/低呼吸指数，从整个夜间PSG计算）。建议的ASAP（tm）系统可以方便地在许多地点使用，从睡眠实验室到精神病学和神经病学办公室/诊所，初级保健医生办公室和工作场所的保健站。该项目的第一阶段将重点开发ASAP（tm）的硬件/软件组件，以及其用于EDS和呼吸暂停筛查/监测的创新算法。该系统还将在睡眠障碍中心对正常和OSA患者进行广泛的临床评估。

DESCRIPTION: The overall goal of this project is to develop a novel ambulatory, easy-to-administer, short-duration, and highly quantitative method of evaluating/screening an individual for excessive sleepiness, as well as his/her propensity for developing sleep-disordered breathing (i.e., sleep apneas/hypopneas). The proposed Ambulatory Sleepiness & Apnea Propensity (ASAP(tm)) evaluation system is a paradigm change in terms of the entire screening/assessment method for the presence of sleep-disordered breathing and excessive sleepiness that affect millions (prevalence of Obstructive Sleep Apnea, OSA, alone is around 4%). It is an innovative approach that simultaneously produces two indices related to (1) excessive daytime sleepiness, and (2) the likelihood of demonstrating respiratory disturbances during sleep, by combining the highly quantitative information acquired during a short duration (approximately 15 minute) Maintenance of Alertness Test (MAT) with a novel analysis of the wake to sleep transition (both neurological and respiratory signals) during a short duration (approximately 30 minutes) subsequent nap. Thus, the "Alertness Index" provided by MAT is combined with the "Sleepiness Index" obtained from the subsequent nap to produce an overall "Excessive Daytime Sleepiness Index". The nap also produces an overall "Apnea-Propensity Index" by a novel and automatic analysis of respiratory variability around the start of sleep onset period. The applicants have provided preliminary analysis of PSG data from patients with a variety of OSA severity (normal, mild, moderate, and severe) showing that the Apnea-Propensity Index, computed around the first wake-sleep transition, demonstrates good correlation (Correlation Coef.=86%) with the clinical indicator of severity of OSA (Apnea/Hypopnea Index, computed from the entire night PSG). The proposed ASAP(tm) system can be conveniently utilized in many locations ranging from sleep laboratories to a psychiatry and neurology office/clinic, primary care physician's office, and health-care stations within workplace. Phase I of this project will focus on developing the hardware/software component of ASAP(tm), as well as its innovative algorithms for EDS and apnea screening/monitoring. The system will also undergo an extensive clinical evaluation at a sleep disorders center with both normal and OSA patients.