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Pulse transit time in screening sleep disordered breathing in an elderly population: the PROOF-SYNAPSE study
Florian Chouchou1, Emilia Sforza, Sébastien Celle
1INSERM, U1028, CNRS, UMR5292, Centre de Recherche en Neurosciences de Lyon, Intégration centrale de la douleur chez l’Homme, Université Claude Bernard, Lyon, F-69000, France.
Sleep
|August 2, 2011
Summary
Pulse transit time (PTT) shows moderate sensitivity for screening sleep disordered breathing (SDB) in healthy older adults. Current data suggests PTT is not a reliable diagnostic tool for SDB in the elderly population.
Area of Science:
- Gerontology
- Sleep Medicine
- Cardiovascular Physiology
Background:
- Sleep disordered breathing (SDB) prevalence increases with age.
- Pulse transit time (PTT) is a potential screening tool for SDB.
- Effectiveness of PTT in elderly populations requires investigation.
Purpose of the Study:
- To evaluate the effectiveness of PTT for screening SDB in a large, healthy elderly population.
- To determine if PTT-derived autonomic arousal index (AAI) can accurately diagnose SDB in older adults.
Main Methods:
- A community-based sample of 780 healthy elderly volunteers (mean age 68.6 years) participated.
- Ambulatory polygraphy measured the apnea-hypopnea index (AHI) to diagnose SDB (AHI ≥ 15).
- Continuous PTT monitoring calculated the overall autonomic arousal index (AAI).
Main Results:
- SDB was diagnosed in 57.3% of subjects.
- The AAI showed moderate sensitivity (70.5%) but low specificity (54.7%) for SDB (AHI ≥ 15) at a cutoff of 32.3 events/hour.
- For predicting severe SDB (AHI ≥ 30), specificity improved to 94.7% but sensitivity dropped to 32.2%.
Conclusions:
- The autonomic arousal index derived from PTT demonstrates moderate sensitivity for SDB prediction in healthy older adults.
- Current findings do not support the use of PTT as a screening tool for diagnosing SDB in the elderly.
