Skip to main content
Erschienen in: Sleep and Breathing 4/2019

07.02.2019 | Sleep Breathing Physiology and Disorders • Original Article

Apnea and hypopnea characterization using esophageal pressure, respiratory inductance plethysmography, and suprasternal pressure: a comparative study

verfasst von: AbdelKebir Sabil, Christoph Schöbel, Martin Glos, Alexandra Gunther, Christian Veauthier, Philipp Arens, Ingo Fietze, Thomas Penzel

Erschienen in: Sleep and Breathing | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To determine if recording of suprasternal pressure (SSP) can classify apneas and hypopneas as reliably as respiratory inductance plethysmography (RIP) belts and to compare the two methods to classification with esophageal pressure (Pes), the reference method for assessing respiratory effort.

Methods

In addition to polysomnographic recordings that included Pes, SSP was recorded. Recordings from 32 patients (25 males, mean age 66.7 ± 15.3 years, and mean BMI 30.1 ± 4.5 kg/m2) were used to compare the classification of detected apneas and hypopneas by three methods of respiratory effort evaluation (Pes, RIP belts, and SSP). Signals were analyzed randomly and independently from each other. All recordings were analyzed according to AASM guidelines.

Results

Using Pes as a reference for apnea characterization, the Cohen kappa (κ) was 0.93 for SSP and 0.87 for the RIP. The sensitivity/specificity of SSP was 97.0%/96.9% for obstructive, 93.9%/98.3% for central, and 94.9%/97.9% for mixed apneas. The sensitivity/specificity of the RIP was 97.4%/91.9% for obstructive, 87.5%/97.9% for central, and 85.6%/96.6% for mixed apneas. For hypopnea characterization using the Pes as a reference, κ was 0.92 for SSP and 0.86 for the RIP. The sensitivity/specificity of SSP was 99.7%/97.6% for obstructive and 97.6%/99.7% for central. The sensitivity/specificity of the RIP was 99.8%/81.1% for obstructive and 81.1%/99.8% for central.

Conclusions

These results confirm the excellent agreement in the detection of respiratory effort between SSP, RIP belts, and Pes signals. Thus, we conclude that apnea and hypopnea characterization in adults with SSP is a reliable method.
Literatur
1.
Zurück zum Zitat Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF, Redline S, Strohl KP, Davidson Ward SL, Tangredi MM, American Academy of Sleep Medicine (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 8(5):597–619PubMedPubMedCentral Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF, Redline S, Strohl KP, Davidson Ward SL, Tangredi MM, American Academy of Sleep Medicine (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 8(5):597–619PubMedPubMedCentral
2.
Zurück zum Zitat Chervin RD, Aldrich MS (1997) Effects of esophageal pressure monitoring on sleep architecture. Am J Respir Crit Care Med 156(3 Pt 1):881–885CrossRef Chervin RD, Aldrich MS (1997) Effects of esophageal pressure monitoring on sleep architecture. Am J Respir Crit Care Med 156(3 Pt 1):881–885CrossRef
3.
Zurück zum Zitat Claman DM, Votteri BA (1998) Effects of esophageal pressure monitoring on sleep architecture. Am J Respir Crit Care Med 157(5 Pt 1):1697–1698CrossRef Claman DM, Votteri BA (1998) Effects of esophageal pressure monitoring on sleep architecture. Am J Respir Crit Care Med 157(5 Pt 1):1697–1698CrossRef
4.
Zurück zum Zitat Chediak AD, Demirozu MC, Nay KN (1990) Alpha EEG sleep produced by balloon catheterization of the esophagus. Sleep 13(4):369–370CrossRef Chediak AD, Demirozu MC, Nay KN (1990) Alpha EEG sleep produced by balloon catheterization of the esophagus. Sleep 13(4):369–370CrossRef
5.
Zurück zum Zitat Ayappa I, Norman RG, Rapoport DM (1999) Cardiogenic oscillations on the airflow signal during continuous positive airway pressure as a marker of central apnea. Chest 116(3):660–666CrossRef Ayappa I, Norman RG, Rapoport DM (1999) Cardiogenic oscillations on the airflow signal during continuous positive airway pressure as a marker of central apnea. Chest 116(3):660–666CrossRef
6.
Zurück zum Zitat Morrell MJ, Badr MS, Harms CA, Dempsey JA (1995) The assessment of upper airway patency during apnea using cardiogenic oscillations in the airflow signal. Sleep 18(8):651–658CrossRef Morrell MJ, Badr MS, Harms CA, Dempsey JA (1995) The assessment of upper airway patency during apnea using cardiogenic oscillations in the airflow signal. Sleep 18(8):651–658CrossRef
7.
Zurück zum Zitat Boudewyns A, Willemen M, Wagemans M, De Cock W, Van de Heyning P, De Backer W (1997) Assessment of respiratory effort by means of strain gauges and esophageal pressure swings: a comparative study. Sleep 20(2):168–170CrossRef Boudewyns A, Willemen M, Wagemans M, De Cock W, Van de Heyning P, De Backer W (1997) Assessment of respiratory effort by means of strain gauges and esophageal pressure swings: a comparative study. Sleep 20(2):168–170CrossRef
8.
Zurück zum Zitat Luo YM, Tang J, Jolley C, Steier J, Zhong NS, Moxham J, Polkey MI (2009) Distinguishing obstructive from central sleep apnea events: diaphragm electromyogram and esophageal pressure compared. Chest 135(5):1133–1141CrossRef Luo YM, Tang J, Jolley C, Steier J, Zhong NS, Moxham J, Polkey MI (2009) Distinguishing obstructive from central sleep apnea events: diaphragm electromyogram and esophageal pressure compared. Chest 135(5):1133–1141CrossRef
9.
Zurück zum Zitat Beckerman RC, Wegmann MJ (1985) A comparison of tracheal breath sounds, airflow, and impedance pneumography in the detection of childhood apnea. Sleep 8(4):342–346CrossRef Beckerman RC, Wegmann MJ (1985) A comparison of tracheal breath sounds, airflow, and impedance pneumography in the detection of childhood apnea. Sleep 8(4):342–346CrossRef
10.
Zurück zum Zitat Beckerman RC, Wegmann MJ, Waring WW (1982) Tracheal breath sounds for detection of apnea in infants and children. Crit Care Med 10(6):363–366CrossRef Beckerman RC, Wegmann MJ, Waring WW (1982) Tracheal breath sounds for detection of apnea in infants and children. Crit Care Med 10(6):363–366CrossRef
11.
Zurück zum Zitat Cummiskey J, Williams TC, Krumpe PE, Guilleminault C (1982) The detection and quantification of sleep apnea by tracheal sound recordings. Am Rev Respir Dis 126(2):221–224PubMed Cummiskey J, Williams TC, Krumpe PE, Guilleminault C (1982) The detection and quantification of sleep apnea by tracheal sound recordings. Am Rev Respir Dis 126(2):221–224PubMed
12.
Zurück zum Zitat Nakano H, Hayashi M, Ohshima E, Nishikata N, Shinohara T (2004) Validation of a new system of tracheal sound analysis for the diagnosis of sleep apnea-hypopnea syndrome. Sleep 27(5):951–957CrossRef Nakano H, Hayashi M, Ohshima E, Nishikata N, Shinohara T (2004) Validation of a new system of tracheal sound analysis for the diagnosis of sleep apnea-hypopnea syndrome. Sleep 27(5):951–957CrossRef
13.
Zurück zum Zitat Amaddeo A, Fernandez-Bolanos M, Olmo Arroyo J, Khirani S, Baffet G, Fauroux B (2016) Validation of a suprasternal pressure sensor for sleep apnea classification in children. J Clin Sleep Med 12(12):1641–1647CrossRef Amaddeo A, Fernandez-Bolanos M, Olmo Arroyo J, Khirani S, Baffet G, Fauroux B (2016) Validation of a suprasternal pressure sensor for sleep apnea classification in children. J Clin Sleep Med 12(12):1641–1647CrossRef
14.
Zurück zum Zitat Glos M, Sabil A, Jelavic KS, Schobel C, Fietze I, Penzel T (2018) Characterization of respiratory events in obstructive sleep apnea using suprasternal pressure monitoring. J Clin Sleep Med 14(3):359–369CrossRef Glos M, Sabil A, Jelavic KS, Schobel C, Fietze I, Penzel T (2018) Characterization of respiratory events in obstructive sleep apnea using suprasternal pressure monitoring. J Clin Sleep Med 14(3):359–369CrossRef
15.
Zurück zum Zitat Meslier N, Simon I, Kouatchet A, Ouksel H, Person C, Racineux JL (2002) Validation of a suprasternal pressure transducer for apnea classification during sleep. Sleep 25(7):753–757CrossRef Meslier N, Simon I, Kouatchet A, Ouksel H, Person C, Racineux JL (2002) Validation of a suprasternal pressure transducer for apnea classification during sleep. Sleep 25(7):753–757CrossRef
16.
Zurück zum Zitat Kushida CA, Giacomini A, Lee MK, Guilleminault C, Dement WC (2002) Technical protocol for the use of esophageal manometry in the diagnosis of sleep-related breathing disorders. Sleep Med 3(2):163–173CrossRef Kushida CA, Giacomini A, Lee MK, Guilleminault C, Dement WC (2002) Technical protocol for the use of esophageal manometry in the diagnosis of sleep-related breathing disorders. Sleep Med 3(2):163–173CrossRef
17.
Zurück zum Zitat Tobin MJ, Cohn MA, Sackner MA (1983) Breathing abnormalities during sleep. Arch Intern Med 143(6):1221–1228CrossRef Tobin MJ, Cohn MA, Sackner MA (1983) Breathing abnormalities during sleep. Arch Intern Med 143(6):1221–1228CrossRef
18.
Zurück zum Zitat Staats BA, Bonekat HW, Harris CD, Offord KP (1984) Chest wall motion in sleep apnea. Am Rev Respir Dis 130(1):59–63PubMed Staats BA, Bonekat HW, Harris CD, Offord KP (1984) Chest wall motion in sleep apnea. Am Rev Respir Dis 130(1):59–63PubMed
19.
Zurück zum Zitat Escourrou P, Meslier N, Raffestin B, Clavel R, Gomes J, Hazouard E et al (2010) Which clinical approach and which diagnostic procedures for obstructive sleep apnea syndrome? Rev Mal Respir 3(27 Suppl):S115–S123CrossRef Escourrou P, Meslier N, Raffestin B, Clavel R, Gomes J, Hazouard E et al (2010) Which clinical approach and which diagnostic procedures for obstructive sleep apnea syndrome? Rev Mal Respir 3(27 Suppl):S115–S123CrossRef
Metadaten
Titel
Apnea and hypopnea characterization using esophageal pressure, respiratory inductance plethysmography, and suprasternal pressure: a comparative study
verfasst von
AbdelKebir Sabil
Christoph Schöbel
Martin Glos
Alexandra Gunther
Christian Veauthier
Philipp Arens
Ingo Fietze
Thomas Penzel
Publikationsdatum
07.02.2019
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 4/2019
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-019-01793-8

Weitere Artikel der Ausgabe 4/2019

Sleep and Breathing 4/2019 Zur Ausgabe

Sleep Breathing Physiology and Disorders • Original Article

Sleep apnea and galectin-3: possible sex-specific relationship

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.