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Related Experiment Videos

Classification of sleep-disordered breathing.

J Hosselet1, I Ayappa, R G Norman

  • 1Division of Pulmonary and Critical Care Medicine, New York University School of Medicine, New York, New York, USA.

American Journal of Respiratory and Critical Care Medicine
|February 17, 2001
PubMed
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A total respiratory disturbance index (RDI) combining all sleep breathing events best identifies excessive daytime somnolence (EDS). An RDI of 18 events/h showed high accuracy in diagnosing EDS in patients with upper airway dysfunction.

Area of Science:

  • Sleep Medicine
  • Respiratory Physiology

Background:

  • Sleep-disordered breathing (SDB) and its associated health problems are increasingly recognized.
  • Current methods for identifying respiratory events during sleep require reevaluation.
  • Objective metrics correlating with excessive daytime somnolence (EDS) are needed.

Purpose of the Study:

  • To evaluate various sleep-disordered breathing (SDB) metrics.
  • To identify the optimal respiratory metric for objectively correlating with excessive daytime somnolence (EDS).

Main Methods:

  • 137 subjects underwent clinical evaluation and polysomnography.
  • Metrics included apneas, hypopneas, flow limitation events, desaturation, and arousals.
  • Receiver operator curve analysis identified discriminant metrics in a subset of subjects.

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Main Results:

  • A total respiratory disturbance index (RDI(Total)) incorporating apneas, hypopneas, and flow limitation events showed the best discriminant ability (100% sensitivity, 96% specificity) at a cutoff of 18 events/h for differentiating EDS from non-EDS subjects in initial analysis.
  • Prospective testing in 103 subjects yielded 71% sensitivity and 60% specificity for identifying EDS using the RDI(Total) cutoff of 18 events/h.

Conclusions:

  • An index that incorporates all respiratory events provides the best quantitative physiological correlate to excessive daytime somnolence (EDS) in subjects with upper airway dysfunction.
  • The total respiratory disturbance index (RDI(Total)) is a promising metric for assessing EDS.