Pharyngoesophageal pressure monitoring in sleep apnea syndrome

Abstract

A Comparative Model in Sleep-Disordered Breathing vs. Alcohol Impaired Controls NELSON B POWELL MD (presenter); ROBERT W RILEY MD DDS; Palo Alto CA Objectives: Patients with sleep-disordered breathing suffer reaction time deficits that may lead to catastrophic accidents and loss of life. Although safety guidelines do not exist for unsafe levels of sleepiness, they have been established for unsafe levels of alcohol consumption. Since reaction time performance is altered in both, we prospectively used 7 measures of reaction time performance as a comparative model in alcohol-challenged normal subjects with corresponding measures in subjects with sleep-disordered breathing. Methods: Eighty healthy volunteers (29.1 _+ 7.5 years old, 56.3% female) performed 4 reaction time trials using a psychomotor test at baseline and at 3 subsequent rising alcoholinfluenced time points. The same test without alcohol was given to 113 subjects (47.2 _+ 10.8 years old, 19.3% female) with mild-to-moderate sleep-disordered breathing. Results: Blood-alcohol concentrations (BACs) in the alcohol subjects at baseline and 3 trials were a mean 0, 0.057, 0.080, and 0.083 g/dL. The sleep subjects had mean respiratory disturbance indices of 29.2 events per hour of sleep. On all 7 reaction time measures, their performances were worse than those of the alcohol subjects when BAC levels were 0.057 g/dL. For 3 of the measures, the sleep-disordered subjects performed as badly or worse than the alcohol subjects when alcohol levels were 0.080 g/dL. These results could not be explained by sex or age differences. Conclusion: The data demonstrate that sleep-disordered 10:46 AM

Esophageal Pressure Monitoring in Detection of Sleep‐Disordered Breathing

“…3 In a recent report, the sensitivity and specificity of esophageal pressure monitoring alone in excluding OSA (AHI Ͻ15) and identifying severe OSA (AHI Ͼ40) were found to be 100%. 19 Other methods of detecting partial obstruction have been developed, 20 -22 but they still lack sufficient methodological studies to be generally accepted in clinical use. 3 The savings achieved by the present two-step investigation were moderate compared with PSG.…”