Periodic, Profound Peripheral Vasoconstriction—A New Marker of Obstructive Sleep Apnea

Schnall, Robert P.; Shlitner, Arie; Sheffy, Jacob; Kedar, Reuven; Lavie, Peretz

doi:10.1093/sleep/22.7.939

Cited by 55 publications

(8 citation statements)

References 16 publications

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“…Arousals from sleep are associated with increased sympathetic activation, which produces peripheral vasoconstriction. Autonomic arousals or central nervous activations can thus be recognized by means of PAT (Schnall et al 1999). The PAT signal is measured with a finger plethysmograph coupled to a constant volume, variable pressure, pneumatic system, which records pulsatile volume changes in the finger tip (Schnall et al 1999).…”

Section: Cardiovascular Measuresmentioning

confidence: 99%

A review of signals used in sleep analysis

et al. 2013

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This article presents a review of signals used for measuring physiology and activity during sleep and techniques for extracting information from these signals. We examine both clinical needs and biomedical signal processing approaches across a range of sensor types. Issues with recording and analysing the signals are discussed, together with their applicability to various clinical disorders. Both univariate and data fusion (exploiting the diverse characteristics of the primary recorded signals) approaches are discussed, together with a comparison of automated methods for analysing sleep.

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Section: Cardiovascular Measuresmentioning

confidence: 99%

A review of signals used in sleep analysis

et al. 2013

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“…Usually, the decrease of the PAT signal amplitude can be seen approximately 7 s after the occurrence of the arousal in the EEG. Arousals recognized in this way correlate significantly with the number of apneas and hypopneas (r = 0.92) which then allow a non-invasive and easy recognition of sleep-related breathing disorders (Schnall et al 1999).…”

Section: Introductionmentioning

confidence: 96%

“…The peripheral arterial tonometry (PAT) is a recently developed method (Schnall et al 1999). The tonometry is based on the pulsatile plethysmographic signal measured on the finger which can serve as a single non-invasive substitute for sympathetic activity.…”

Section: Introductionmentioning

confidence: 99%

Peripheral arterial tonometry, oximetry and actigraphy for ambulatory recording of sleep apnea

et al. 2004

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Autonomous nervous functions change with sleep stages and show characteristic changes associated with sleep disorders. Therefore, continuous monitoring of autonomous nervous functions during sleep can be used for diagnostic purposes. Recently, the peripheral arterial tonometry (PAT) has been introduced to determine peripheral arterial vascular tone on the finger being determined by sympathetic activity. We investigate a new ambulatory recording system which uses PAT, oximetry and actigraphy (Watch-PAT) in order to detect sleep apnea and arousal. The Watch-PAT is battery operated and attached to the wrist and has two finger sensors. Twenty-one patients with suspected sleep apnea were recorded with cardiorespiratory polysomnography and the new system in parallel. Seventeen recordings could be evaluated. The correlation for the apnea/hypopnea index derived from the sleep laboratory and the respiratory disturbance index derived from the Watch-PAT was r = 0.89 (p < 0.01) and between arousals and the respiratory disturbance index was r = 0.77 (p < 0.01). The correlation for the total sleep time compared between the two systems was r = 0.15 (n.s.). The Watch-PAT detects apneas and hypopneas with a reasonable reliability and it is very sensitive to arousals. The number of Watch-PAT events lies between the sum of apneas plus hypopneas and arousals. Arousals are not unique to apnea events and therefore the specifity of the Watch-PAT is limited. In conclusion, the Watch-PAT is well suited to perform therapy control studies in patients suffering from sleep apnea and being treated.

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“…The visible end-points of these autonomic arousals are changes in skin vasoconstriction, heart rate and blood pressure (figure 4). The former can be measured in a variety of ways, one of these using an adapted finger plethysmograph has reported good correlations with AHI R = 0.92 (Schnall et al 1999). Blood pressure rises also correlate with AHI from classical polysomnography albeit slightly less well (R = 0.56), and the correlation between AHI and heart rate arousals, is only 0.38 (Pitson and Stradling 1998a).…”

Section: Autonomic Markers Of Sleep Fragmentationmentioning

confidence: 99%

Sleep studies for sleep apnoea

2002

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Sleep studies have grown to encompass a broad range of technologies employed to study and diagnose a variety of sleep disorders. From their inception in neurophysiology laboratories interested in investigating primary disorders of sleep architecture from psychiatric illness, their remit has widened such that their most common role is currently to diagnose secondary sleep disruption from respiratory, cardiovascular or other systemic causes. This review outlines the pathophysiology of obstructive sleep apnoea in particular and how sleep studies have improved our understanding of the complex dynamic changes in blood gas tensions, cardiovascular control and cerebral arousal that occur with these repetitive events. We review the historical development of standard laboratory-based sleep studies and discuss their limitations in staging sleep, reflecting the episodes of increased upper airway resistance that underlie these disorders and their ability to predict individuals' symptoms or response to medical or surgical therapies. We then describe some alternative signals that have been employed to monitor the physiological changes in upper airway resistance and arousal with a discussion of some of the evidence that these 'limited' studies may provide diagnostic information that can guide clinical decision making and may predict the outcome without the need, in some cases, for more complex and costly laboratory-based studies.

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Periodic, Profound Peripheral Vasoconstriction—A New Marker of Obstructive Sleep Apnea

Cited by 55 publications

References 16 publications

A review of signals used in sleep analysis

A review of signals used in sleep analysis

Peripheral arterial tonometry, oximetry and actigraphy for ambulatory recording of sleep apnea

Sleep studies for sleep apnoea

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