Detection of Sleep Apnea with the Forced Oscillation Technique Compared to Three Standard Polysomnographic Signals

Reisch, S.; Daniuk, J.; Steltner, Holger; Rühle, K.-H.; Timmer, Jens; Guttmann, J.

doi:10.1159/000067467

Cited by 14 publications

(11 citation statements)

References 16 publications

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“…It is well supported theoretically and has the advantage of being convenient, noninvasive and requiring minimal cooperation of the patient. Therefore, it has been used to monitor air flow obstruction in sleep and titrating continuous positive airway pressure parameters [14, 15]. …”

Section: Introductionmentioning

confidence: 99%

Effect of Posture on Airway Resistance in Obstructive Sleep Apnea-Hypopnea Syndrome by Means of Impulse Oscillation

et al. 2008

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Background: There is more than one mechanism which contributes to the increases in upper airway resistance in obstructive sleep apnea and hypopnea syndrome. Impulse oscillation provides a convenient way of noninvasive monitoring and differentiating the contributions of airway resistance. Objective: To evaluate the effect of posture on airway resistance in obstructive sleep apnea-hypopnea syndrome (OSAHS) by means of impulse oscillation. Methods: Ten subjects without OSAHS proved by polysomnography served as controls, 14 patients with mild or moderate OSAHS and another 20 severe OSAHS patients were studied. All subjects underwent an overnight sleep study. Airway resistance was measured by impulse oscillometry, and spirometry was performed in the seated position and then in the supine position while awake. Results: Compared with controls, the severe and the mild-moderate OSAHS groups had significantly bigger changes in Zrs, Rrs5, R20 and R35 due to posture. There were also significant differences in R10, R15 and R25 between the severe OSAHS and the control groups. Besides, the group differences between the severe and the mild-moderate groups regarding the magnitude of this change were not significant. The correlation coefficients between apnea/hypopnea index and Zrs, R5 and R20 in supine position were 0.487, 0.486 and 0.485, respectively. Conclusion: The magnitude of change in airway resistance due to posture is bigger in OSAHS than in non-OSAHS. Zrs, R5 and R20 in supine position were associated moderately with apnea/hypopnea index.

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Section: Introductionmentioning

confidence: 99%

Effect of Posture on Airway Resistance in Obstructive Sleep Apnea-Hypopnea Syndrome by Means of Impulse Oscillation

et al. 2008

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“…However, the sensor must be placed by an expert, it is invasive and alters the patient's sleep. Instead of using Pes to score sleep apneas and hypopneas (SAHs), non-invasive Pes surrogates were studied or are still under study, such as pulse transit time (PTT) [20], forced oscillation technique (FOT) [21], [22], nasal airflow (NAF) [13]- [16] and thoraco-abdominal movements (TAM) [11], [17], [18]. This paper proposed a novel non-invasive easy-to-use Pes surrogate, the midsagittal jaw movements, and a dedicated automatic method to score SAHs without the use of the nasal flow signal.…”

Section: Resultsmentioning

confidence: 99%

“…This method consists in the application of a low amplitude pressure at a frequency of 5 to 20 Hz by a mask pressure. From the flow and the pressure both recorded, the FOT signal is extracted and associated with the flow signal to score SAHs using a breath-by-breath Despite a cumbersome apparatus, the obstructive and central nature of a respiratory event is accurately found [21], [22]. Other automated methods for SAHs detection (without classification of respiratory events) have been recently developed to diagnose OSAHS using ambulatory measurement and the analysis of the pulse arterial tonometry (PAT) [23], [24] or ECG [25], [26].…”

Section: Introductionmentioning

confidence: 99%

Midsagittal Jaw Movement Analysis for the Scoring of Sleep Apneas and Hypopneas

Senny

Destiné

Poirrier

2008

IEEE Trans. Biomed. Eng.

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Given the importance of the detection and classification of sleep apneas and hypopneas (SAHs) in the diagnosis and the characterization of the SAH syndrome, there is a need for a reliable non-invasive technique measuring respiratory effort. This paper proposes a new method for the scoring of SAHs based on the recording of the midsagittal jaw motion (mouth opening) and on a dedicated automatic analysis of this signal. Continuous wavelet transform is used to quantize respiratory effort from the jaw motion, to detect salient mandibular movements related to SAHs and to delineate events which are likely to contain the respiratory events. The classification of the delimited events is performed using multi-layer perceptrons which were trained and tested on sleep data from 34 recordings. Compared with SAHs scored manually by an expert, the sensitivity and specificity of the detection were 86.1% and 87.4% respectively. Moreover, the overall classification agreement in the recognition of obstructive, central and mixed respiratory events between the manual and automatic scorings was 73.1%. The midsagittal jaw motion signal is hence a reliable marker of respiratory effort and allows an accurate detection and classification of SAHs.

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“…Besides, this technique could also be relevant for treatment with continuous positive airway pressure devices that usually only target upper airway obstruction and in most cases exclusively record the airflow signal [12]. Several noninvasive methods have been suggested for the detection and/or differentiation of central and obstructive apneas/hypopneas, such as diaphragmatic/intercostal electromyography [7], pulse-transit time [6], forced oscillation technique [13,14,15] and artificial neural networks [16]. However, most of these methods require multichannel and complex technical procedures that are usually not feasible in clinical practice, limiting their widespread adoption.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Noninvasive Single-Channel Automated Differentiation of Obstructive and Central Hypopneas with Nasal Airflow

Morgenstern

Randerath

Schwaibold³

et al. 2012

Respiration

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Background: The identification of obstructive and central hypopneas is considered challenging in clinical practice. Presently, obstructive and central hypopneas are usually not differentiated or scores lack reliability due to the technical limitations of standard polysomnography. Esophageal pressure measurement is the gold-standard for identifying these events but its invasiveness deters its usage in daily practice. Objectives: To determine the feasibility and efficacy of an automatic noninvasive analysis method for the differentiation of obstructive and central hypopneas based solely on a single-channel nasal airflow signal. The obtained results are compared with gold-standard esophageal pressure scores. Methods: A total of 41 patients underwent full night polysomnography with systematic esophageal pressure recording. Two experts in sleep medicine independently differentiated hypopneas with the gold-standard esophageal pressure signal. Features were automatically extracted from the nasal airflow signal of each annotated hypopnea to train and test the automatic analysis method. Interscorer agreement between automatic and visual scorers was measured with Cohen's kappa statistic (ĸ). Results: A total of 1,237 hypopneas were visually differentiated. The automatic analysis achieved an interscorer agreement of ĸ = 0.37 and an accuracy of 69% for scorer A, ĸ = 0.40 and 70% for scorer B and ĸ = 0.41 and 71% for the agreed scores of scorers A and B. Conclusions: The promising results obtained in this pilot study demonstrate the feasibility of noninvasive single-channel hypopnea differentiation. Further development of this method may help improving initial diagnosis with home screening devices and offering a means of therapy selection and/or control.

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Detection of Sleep Apnea with the Forced Oscillation Technique Compared to Three Standard Polysomnographic Signals

Cited by 14 publications

References 16 publications

Effect of Posture on Airway Resistance in Obstructive Sleep Apnea-Hypopnea Syndrome by Means of Impulse Oscillation

Effect of Posture on Airway Resistance in Obstructive Sleep Apnea-Hypopnea Syndrome by Means of Impulse Oscillation

Midsagittal Jaw Movement Analysis for the Scoring of Sleep Apneas and Hypopneas

Feasibility of Noninvasive Single-Channel Automated Differentiation of Obstructive and Central Hypopneas with Nasal Airflow

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