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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Apnoeic and obstructive nonapnoeic sleep respiratory events
1Pulmonary Service, San Pedro de Alcántara Hospital, Cáceres, Spain. fmasa@separ.es
The European Respiratory Journal
|February 14, 2009
Summary
Obstructive nonapnoeic events (ONEs) are confusing to score, especially in mild disease. This study clarifies ONE scoring using esophageal pressure and noninvasive methods, improving accuracy for sleep apnea patients.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
Background:
- Obstructive nonapnoeic event (ONE) scoring lacks clarity, particularly for patients with mild sleep apnea.
- Accurate scoring is crucial for precise diagnosis and treatment in mild cases.
Purpose of the Study:
- To identify ONEs using esophageal pressure (OP-ONEs) and noninvasive (NI-ONEs) methods.
- To compare the agreement between OP-ONEs and NI-ONEs.
- To assess the impact of ONE definitions on clinical findings, especially sleepiness.
Main Methods:
- Patients with suspected sleep apnea underwent polysomnography with esophageal pressure monitoring.
- ONEs were defined by esophageal pressure increases or reduced thoracoabdominal band amplitude, with desaturation and/or arousal.
- Bland-Altman analysis was used to compare scoring methods.
Main Results:
- Including arousal in ONE definitions significantly increased event counts (329-362%).
- Noninvasive ONEs with arousal and/or desaturation detected 91% of esophageal pressure-defined ONEs.
- The association with sleepiness was dependent on incorporating arousal into the ONE definition.
Conclusions:
- Noninvasive scoring of obstructive nonapnoeic events, incorporating arousal, is accurate and easier for mild sleep apnea.
- Refined ONE definitions have significant implications for respiratory disturbance index calculation and potential treatment decisions.
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