دورية أكاديمية
أعرض في EDS

Flow limitation/obstruction with recovery breath (FLOW) event for improved scoring of mild obstructive sleep apnea without electroencephalography.

التفاصيل البيبلوغرافية
العنوان: Flow limitation/obstruction with recovery breath (FLOW) event for improved scoring of mild obstructive sleep apnea without electroencephalography.
المؤلفون: Johnson KG; Department of Neurology, Baystate Medical Center, University of Massachusetts Medical School-Baystate, 759 Chestnut St, Springfield, MA, 01199, USA; Institute for Healthcare Delivery and Population Science and Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA. Electronic address: karin.johnson@bhs.org., Johnson DC; Department of Medicine, Baystate Medical Center, University of Massachusetts Medical School-Baystate, 759 Chestnut St, Springfield, MA, 01199, USA., Thomas RJ; Division of Pulmonary, Critical Care & Sleep, Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA. Electronic address: rthomas1@bidmc.harvard.edu., Feldmann E; Department of Neurology, Baystate Medical Center, University of Massachusetts Medical School-Baystate, 759 Chestnut St, Springfield, MA, 01199, USA., Lindenauer PK; Institute for Healthcare Delivery and Population Science and Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA; Department of Medicine, Baystate Medical Center, University of Massachusetts Medical School-Baystate, 759 Chestnut St, Springfield, MA, 01199, USA; Department of Quantitative Health Sciences University of Massachusetts Medical School, Worcester, MA, USA., Visintainer P; Institute for Healthcare Delivery and Population Science and Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA., Kryger MH; Division of Pulmonary, Critical Care and Sleep Medicine, Yale New Haven Medical Center, Yale School of Medicine, 20 York Street New Haven, CT, 06510, USA. Electronic address: meir.kryger@yale.edu.
المصدر: Sleep medicine [Sleep Med] 2020 Mar; Vol. 67, pp. 249-255. Date of Electronic Publication: 2018 Nov 30.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier Science Country of Publication: Netherlands NLM ID: 100898759 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-5506 (Electronic) Linking ISSN: 13899457 NLM ISO Abbreviation: Sleep Med Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Amsterdam ; New York : Elsevier Science, c2000-
مواضيع طبية MeSH: Respiratory System* , Snoring*, Sleep Apnea, Obstructive/*physiopathology, Arousal ; Female ; Humans ; Male ; Polysomnography ; Reproducibility of Results
مستخلص: Objective: Apnea/hypopnea index (AHI), especially without arousal criteria, does not adequately risk stratify patients with mild obstructive sleep apnea (OSA). We describe and test scoring reliability of an event, Flow Limitation/Obstruction With recovery breath (FLOW), representing obstructive airflow disruptions using only pressure transducer and snore signals available without electroencephalography.
Methods: The following process was used (i) Development of FLOW event definition, (ii) Training period and definition refinement, and (iii) Reliability testing on 10 100-epoch polysomnography (PSG) samples and two 100-sample tests. Twenty full-night in-laboratory baseline PSGs in OSA patients with AHI with ≥4% desaturations <15 were rescored for FLOW events, traditional hypopneas with desaturations, respiratory-related arousal (RRA) events (hypopneas with arousals and respiratory-effort related arousals) and non-respiratory arousals (NRA).
Results: Scoring of FLOW events in 100-epoch samples had good reliability with intraclass correlation (ICC) of 0.91. The overall kappa for presence of events on two sets of 100 sample events was 0.84 and 0.87 demonstrating good agreement. Moreover, 80% of RRA and 8% of NRA were concurrent with FLOW events. Furthermore, 56% of FLOW events were independent of RRA events. FLOW stratifies patients in traditional AHI categories with 50%/8% of AHI with ≥3% desaturations (AHI3) <5 and 12%/63% of AHI3 >5 in lowest/highest tertiles of AHI3 plus FLOW index.
Conclusions: Scoring of FLOW after training is reliable. FLOW scores a high proportion of RRA and many currently unrepresented obstructive airflow disruptions. FLOW allows for stratification within the current normal-mild OSA category, which may better identify patients who will benefit from treatment.
(Copyright © 2018 Elsevier B.V. All rights reserved.)
التعليقات: Comment in: Sleep Med. 2020 Mar;67:248. (PMID: 32067899)
References: Respir Physiol Neurobiol. 2007 Nov 15;159(2):219-26. (PMID: 17869189)
J Clin Sleep Med. 2015 Dec 15;11(12):1425-31. (PMID: 26285111)
Sleep. 1996 Nov;19(9 Suppl):S111-6. (PMID: 9122567)
Sleep Med. 2012 Jun;13(6):656-62. (PMID: 22608672)
Eur Clin Respir J. 2016 Sep 06;3:31806. (PMID: 27608271)
Eur Respir J. 2001 Oct;18(4):672-6. (PMID: 11716173)
Am J Respir Crit Care Med. 1994 Aug;150(2):475-80. (PMID: 8049832)
N Engl J Med. 2000 May 11;342(19):1378-84. (PMID: 10805822)
Sleep Breath. 2013 May;17(2):873-6. (PMID: 22733532)
Am J Respir Crit Care Med. 2018 Feb 1;197(3):310-312. (PMID: 29035088)
Sleep Sci. 2015 Nov;8(3):134-42. (PMID: 26779320)
Gend Med. 2007 Dec;4(4):329-38. (PMID: 18215724)
Biometrics. 1977 Mar;33(1):159-74. (PMID: 843571)
J Clin Sleep Med. 2017 Mar 15;13(3):479-504. (PMID: 28162150)
Psychol Bull. 1979 Mar;86(2):420-8. (PMID: 18839484)
Am J Respir Crit Care Med. 2000 Jul;162(1):252-7. (PMID: 10903250)
Sleep Breath. 2016 Dec;20(4):1169-1174. (PMID: 26969658)
Sleep. 2013 Jan 01;36(1):15-21. (PMID: 23288967)
Thorax. 2018 May;73(5):472-480. (PMID: 28935698)
Clinics (Sao Paulo). 2014 Nov;69(11):731-4. (PMID: 25518029)
Lung. 2009 Mar-Apr;187(2):82-92. (PMID: 19219502)
Am J Respir Crit Care Med. 2016 May 1;193(9):e37-54. (PMID: 27128710)
Ann Am Thorac Soc. 2017 Jul;14(7):1076-1085. (PMID: 28665698)
Curr Opin Pulm Med. 2017 Nov;23(6):506-511. (PMID: 28858969)
Lancet Respir Med. 2015 Apr;3(4):310-8. (PMID: 25682233)
Comput Methods Programs Biomed. 2007 Jan;85(1):8-18. (PMID: 17084481)
J Psychiatr Res. 2006 Apr;40(3):273-9. (PMID: 16473570)
معلومات مُعتمدة: K24 HL132008 United States HL NHLBI NIH HHS; UL1 TR001863 United States TR NCATS NIH HHS
فهرسة مساهمة: Keywords: Breathing physiology; Flow limitation; Home sleep apnea testing; OSA; Scoring
تواريخ الأحداث: Date Created: 20181226 Date Completed: 20210405 Latest Revision: 20210919
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC6548700
DOI: 10.1016/j.sleep.2018.11.014
PMID: 30583916
قاعدة البيانات: MEDLINE
الوصف
تدمد:1878-5506
DOI:10.1016/j.sleep.2018.11.014