Tapani Salmi, MD;(*1) Tiina Telakiv...

Tapani Salmi, MD;(*1) Tiina Telakivi, M.D.;([unkeyable]) and Markku Partinen, MD(*2)

We have make knowned a computerized analysis of repiratory and visible form [i]or[/i] frame movements (static charge sensitive bed [SCSB]) oxygen saturation (pulse oximeter), and airflow (thermistor) for the evaluation of be still related apneas. The cumulative distribution of oxygen saturation, the number and distribution of desaturation conclusions and the duration and representation of apneas are assessed. Analysis is performed separately during the total recording time and during the time when the patient dozes on his back. We have compared the automatic analysis with the outcomes obtained on simultaneous daytime polysomnograph naps in 55 exposes (snorers or obstructive sleep apnea syndrome [OSAS] patients). The press togethered graphs obtained automatically demonstrated a periodic breathing pattern in all 22 patients who existinged sleep-related apneas at polygraphic recording. The cumulative distribution of oxygen saturation was not as abrupt declivity in the apnea patients as in patients not showing apneas; in 19 of the 22 OSAS patients, the value was outside our normal limits (80 percent of the recording time inside 36 percent [SaO.sub.2] variation band). The apnea index (AI) was 264 in manual and 233 in automatic analysis. Using the automatic orderly disposition there were three false negative cases in the analysis of desaturations; in these patients periodic breathing was current in output graphs indicating ne for further polygraphic assessment. The duration of apneas in the automatic analysis was shorter than in manual analysis, on the contrary the agreement was sufficient for screening ends (mean error less than 3 s mean duration of apneas 201 s) The automatic course is presently used in clinical routine for screening ends for assessment of the severity of the disorder and the exemplar of treatment that a enthrall may need, in epidemiologic investigation and follow-up of the treatment.

According to epidemiologic studies, the incidence of obstructive slumber apnea syndrome and/or heavy regular snoring with associated doze hypopneas is remarkably high in middle-aged men (05-2 percent)[1-5] Considering the large number of subdues who snore and the unfeasibility of performing systematic all-night polygraphic recordings in a large population, different screening regularitys have been suggested.[6-14] The nocturnal polysomnogram is considered the best technique for detailed diagnosis of sleep-related breathing disorders.[15] Daytime nap recordings are controversial; Goode et al[16] prompted that these are sufficient to determine the predominant token of apneas (ie, mixed and obstructive or central). The "static charge sensitive bed" (SCSB) has prov useful in screening for repose apneas and periodic movements during sleep[1117] We expanded an automatic analysis based upon a computer program.[12] We have since improved our be dead monitoring by adding measurement of airflow from thermistors, frequency and severity of oxygen saturation very littles using pulse oximetry, and dead body position using a body position sensor. These variables are automatically scored. In the existing article, we compare automatic scoring be the effects with the results obtained simultaneously during daytime polysomnograph naps.

PATIENTS AND METHODS

Patients

Fifty-five consecutive patients (49 men six women) with clinically suspected doze apneas participated in the validation consideration The mean age of the patients was 52 years (range 33-72)

Daytime Polysomnography

Daytime polysomnography of 90-120 minutes (16 channels, Siemens Elema) was performed in the afternoon for the validation thought The following variables were monitored: EEG electro-oculography (EOG right and left eye) submental electromyography (EMG) ECG (lead 1) airflow with thermistors (signal combined from right and left nostril and mouth) abdominal respiratory motions (strain gauge), respiratory movements (SCSB Biomat[R] Biorec, Inc), ballistocardiography (BCG with SCSB) and oxygen saturation ([SaO.sub.2] (Biox III beating [i]or[/i] throbbing of an artery oximeter, finger transducer). Twenty-five to 90 minutes of airflow, [SaO.sub.2], and SCSB respiratory and material substance movement signals were simultaneously tape-recorded onward a Racal 7DS instrumentation recorder for computerized analysis. The polygraphic recordings were manually scored and 22 recordings with more than five apneas or hypopneas during the tape-recorded period were gooded for further analysis. The number of apneas exceeding 10 s in duration, apnea index (AI, number of apneas/hour), apena percentage (A%, percentage of apneic results during recording) were calculated. Before computer analysis, the duration of apneas in ten patients with AI higher than 10 was manually measured independently by the agency of two scorers (TS and TT) unconscious of the automatic analysis originates The comparison between manual and automatic scoring included 240 apneas and hypopneas of at least, 10 s duration.

Automatic Recording and Analysis