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Quantifying the Arousal Threshold Using Polysomnography in Obstructive Sleep Apnea.

Scott A Sands1,2, Philip I Terrill3, Bradley A Edwards1,4,5

  • 1Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.

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|December 12, 2017
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Summary
This summary is machine-generated.

This study introduces an automated method to measure the respiratory arousal threshold in obstructive sleep apnea (OSA) patients using polysomnography. This technique aids in developing personalized treatments for OSA.

Keywords:
arousabilityendotypepathophysiologypersonalized medicine

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Area of Science:

  • Sleep Medicine
  • Respiratory Physiology
  • Medical Technology

Background:

  • Precision medicine for obstructive sleep apnea (OSA) necessitates accurate, noninvasive patient trait quantification.
  • Understanding the respiratory arousal threshold is crucial for tailoring OSA treatments.

Purpose of the Study:

  • To develop and validate an automated technique for estimating the respiratory arousal threshold in OSA patients.
  • To utilize diagnostic polysomnography signals for noninvasive arousal threshold measurement.

Main Methods:

  • A respiratory control model was fitted to polysomnographic ventilation data to estimate ventilatory drive preceding arousals.
  • Arousal threshold estimates were compared against gold-standard esophageal pressure and diaphragm EMG measurements.
  • Validation included comparisons with continuous positive airway pressure (CPAP) dial-downs and assessment of nasal pressure versus pneumotachograph ventilation.

Main Results:

  • Polysomnographic arousal threshold measures showed strong correlations with esophageal pressure/diaphragm EMG (R=0.79, R=0.73) and CPAP manipulation (R=0.73).
  • Estimates using nasal pressure were highly consistent with pneumotachograph ventilation (R=0.96).

Conclusions:

  • An automated method using polysomnography effectively estimates the arousal threshold in OSA patients.
  • This noninvasive approach may facilitate personalized therapeutic interventions, particularly for individuals with a low arousal threshold.