Which is more important: the number or duration of respiratory events to determine the severity of obstructive sleep apnea?

Durmaz, Dilber Yılmaz; Güneş, Aygül

doi:10.1080/13685538.2019.1630062

Cited by 8 publications

(6 citation statements)

References 11 publications

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“…For hypopneas, increased hypopnea duration may worsen SpO2 desaturation, but hypopneas were reported to lead to less severe SpO2 desaturation compared to obstructive apneas 7 . A similar study by Yılmaz Durmaz and Gunes reported that longer mean hypopnea duration was related to lower mean oxygen saturation but was not associated with an oxygen desaturation event below 85% 8 . The common ground is that the worse oxygen desaturation can come from more events or longer duration of hypopnea.…”

Section: Introductionmentioning

confidence: 65%

“…Respiratory disturbances can have unique characteristics even though the numbers are similar 8 . The AHI, which comprises the number of apneas and hypopneas, incorporates no information of the duration of these events.…”

Section: Discussionmentioning

confidence: 99%

“…Oxygen desaturation is associated with event duration 5 – 8 . For both components (of apnea and hypopnea), OSA patients with long average apnea–hypopnea duration had worse mean oxygen saturation percentage than the patients with short average duration 5 .…”

Section: Introductionmentioning

confidence: 99%

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Negative impact of the hypopnea index or duration increase after a non-frame work surgery in patients with very severe obstructive sleep apnea

Huang

Lin

et al. 2022

Sci Rep

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A non-framework surgery could change the postoperative components of breathing disturbances and increase the frequency or duration of hypopnea in patients with very severe obstructive sleep apnea (OSA). Either an increase of hypopnea index, which increases apnea–hypopnea index (AHI), or an increase of its duration raises the concern of worsening the oxygen desaturation and so morbidity and mortality associated with OSA. It is unclear how the oxygen saturation would change in those having increased frequency or duration of hypopneas after the surgery. Here in 17 patients with AHI ≥ 60 events/h, having increased frequency or duration of hypopneas after the non-framework surgery, the results show that the surgery improved oxygen saturation by reducing obstructive-apnea index (36.1 events/h) and duration (8.6 s/event), despite it increased hypopnea index (16.8 events/h) and duration (9.8 s/event). The surgery improved the average of the mean oxyhemoglobin saturation of pulse oximetry (SpO2) by 2.8% (toward a ceiling mean of 94.3%), mean minimal SpO2 by 7.5%, and mean desaturation by 5%. The results suggest sufficient apnea reduction and shift from apnea to hypopnea may mask the negative impact of the increase of hypopnea index or duration and improve postoperative mean SpO2, minimal SpO2, and mean desaturation.

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Section: Introductionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

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Negative impact of the hypopnea index or duration increase after a non-frame work surgery in patients with very severe obstructive sleep apnea

Huang

Lin

et al. 2022

Sci Rep

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“…Clearly, within the same severity of SA, shorter apnea-hypopnea duration and shallower desaturation may have different consequences than longer and deeper ones. The findings of [46] have supported that while the AHI reflected the frequency of respiratory events, parameters related to event duration such as mean total apnea duration (MTAD), mean central apnea duration (MCAD), mean obstructive apnea duration (MOAD), and mean mixed apnea duration (MMAD) can represent the severity of respiratory events in varying degrees.…”

Section: B System Evaluationmentioning

confidence: 78%

Unobtrusive Screening of Central Sleep Apnea From Pressure Sensors Measurements: A Patient-Specific Longitudinal Study

Azimi

Bouchard

Goubran

et al. 2020

IEEE Trans. Instrum. Meas.

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Historically, the lack of patients' sleep histories has caused low identification of sleep apnea (SA) and referral rates. Moreover, the costly and time-consuming nature of polysomnography (PSG) as a standard clinical test for detecting SA and the lack of sleep clinics has created a demand for suitable home-based monitoring devices. Pressure measurement using a pressure sensitive mat (PSM) can address the challenges found in current sleep-monitoring solutions. The noncontact PSM has a potential to replace obtrusive breathing sensors in the sleep lab and to be used as a prescreening tool for patients suspected of having SA. Applying classical support vector machine (SVM), this article presents a personalized system based on the measurements of each patient to detect central SA (CSA) events and monitor sleep characteristics longitudinally. For this purpose, sensor set-ups were installed in nine seniors' homes to collect unsupervised pressure data in approximately one year ranging from 8 to 12 months. Cost-based and resampling-based approaches were examined to combat imbalanced data. The results showed that the cost-based method outperformed other methods. Next, the patient-specific system was used to determine the total number of CSA events, as well as their starting time and duration in each day. The SA severity was measured by the central apnea index (CAI). In addition, other sleep characteristics such as bed occupancy (BO), day clock, and night clock were extracted from the PSM measurements. The impact of longitudinal sleep monitoring could be in tracking SA treatment progression, and possibly providing information on the interaction between SA and other disease progressions.

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“…Respiratory event induced oxygen desaturation is determined by the duration of apnea/hypopnea, type of respiratory event, functional residual capacity and basic SaO 2 level. 22 , 23 First, apnea could be scored by airflow signals (cessation of breath for 10 secs or more) without oxygen desaturation in PSG. This is important in younger population with no significant comorbidities, and those with low BMI, as they may have a higher incidence of apneas without oxygen desaturations.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Ring Pulse Oximetry Using Reflective Photoplethysmography and PSG in the Detection of OSA in Chinese Adults: A Pilot Study

Zhao¹,

Xue²,

Zhang³

et al. 2022

NSS

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Objective A novel ring-worn oximeter (Circul) uses reflective photoplethysmography and automated signal processing to calculate oxygen desaturations. We evaluated the ability of Circul to detect obstructive sleep apnea in Chinese adults. Methods We recruited 207 Chinese Han subjects: 70% males, mean age 48.2±14.7 years, mean BMI 27.6±4.8 kg/m2 and mean AHI 28.6±25.2 events/h. All participants underwent simultaneous polysomnography (PSG) and Circul testing in a sleep laboratory. Oxygen desaturation index (ODI), mean oxygen saturation (MSpO 2 ), cumulative time at SpO2<90% (CT90), cumulative percentage of sleep time spent with SpO2<90% (CT90/TST) were derived and compared for the Circul and the PSG. Results The ODI was 25.3±24.5 events/h using PSG and 22.2±24.5 events/h using Circul (P<0.0001), with an intraclass correlation coefficient (ICC) of 0.884. CT90 and CT90/TST between the two methods were not different; the MSpO 2 level calculated by PSG was slightly lower than Circul, 95.0% (93.0–96.0%) vs 95.3% (93.9–96.6%), P<0.0001. Circul-ODI had a good correlation (r=0.91, p<0.0001) and close agreement with PSG-AHI (Bland-Altman analysis: Mean Difference 6.4, 95% CI −14.8 to 27.5 events/h). Using a threshold of AHI ≥5 events/h, the Circul had 87% sensitivity, 83% specificity, 5.09 positive likelihood ratio (LR+), 86% accuracy, and 0.929 area under the curve (AUC). Conclusion Circul ring pulse oximetry can detect OSA with reasonable reliability. The Circul system is a reliable and comfortable choice for OSA assessment.

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Which is more important: the number or duration of respiratory events to determine the severity of obstructive sleep apnea?

Cited by 8 publications

References 11 publications

Negative impact of the hypopnea index or duration increase after a non-frame work surgery in patients with very severe obstructive sleep apnea

Negative impact of the hypopnea index or duration increase after a non-frame work surgery in patients with very severe obstructive sleep apnea

Unobtrusive Screening of Central Sleep Apnea From Pressure Sensors Measurements: A Patient-Specific Longitudinal Study

Comparison of Ring Pulse Oximetry Using Reflective Photoplethysmography and PSG in the Detection of OSA in Chinese Adults: A Pilot Study

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