Portable monitoring in sleep apnea

Portable sleep apnea monitoring or home testing for sleep-disordered breathing focuses on recent developments of these powerful diagnostic tools. Evidence-based reviews and innovative single studies with specific systems are considered. Systems become less intrusive and self applicable. Electrocardiogram-derived respiration, photoplethysmogram analysis, midsagittal jaw movements, and respiratory sound analysis are reviewed. Categories of systems with 4 to 6 channels and 1 to 3 channels are introduced and presented. The importance of a high pretest probability is elucidated. Open research questions regarding these systems are mentioned. Technological issues are not most important in this debate. The health economic aspects in using portable sleep apnea monitoring have to be considered as well. Portable monitoring of sleep apnea is probably less expensive than cardiorespiratory polysomnography and can help to overcome the limited availability of sleep lab-based diagnostic places. But by increasing the quantity of investigations it may cause additional costs too.

[1]  J. Fleetham,et al.  Initial use of portable monitoring versus polysomnography to confirm obstructive sleep apnea in symptomatic patients: an economic decision model. , 2010, Sleep medicine.

[2]  C. Heneghan,et al.  A portable automated assessment tool for sleep apnea using a combined Holter-oximeter. , 2008, Sleep.

[3]  W. Flemons,et al.  Home diagnosis of sleep apnea: a systematic review of the literature. An evidence review cosponsored by the American Academy of Sleep Medicine, the American College of Chest Physicians, and the American Thoracic Society. , 2003, Chest.

[4]  Eugenijus Kaniusas,et al.  Acoustical signal properties for cardiac/respiratory activity and apneas , 2005, IEEE Transactions on Biomedical Engineering.

[5]  Atul Malhotra,et al.  Sleep staging based on autonomic signals: a multi-center validation study. , 2011, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[6]  I. Fietze,et al.  Diagnostik in der Schlafmedizin , 2011 .

[7]  A. Chesson,et al.  The American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications , 2007 .

[8]  N. Collop,et al.  Executive summary on the systematic review and practice parameters for portable monitoring in the investigation of suspected sleep apnea in adults. , 2004, American journal of respiratory and critical care medicine.

[9]  N. Ayas,et al.  Diagnosis and Initial Management of Obstructive Sleep Apnea without Polysomnography , 2007, Annals of Internal Medicine.

[10]  Zahra Moussavi,et al.  Sleep apnea monitoring and diagnosis based on pulse oximetery and tracheal sound signals , 2010, Medical & Biological Engineering & Computing.

[11]  M. Chappell,et al.  Combined index of heart rate variability and oximetry in screening for the sleep apnoea/hypopnoea syndrome , 2003, Journal of sleep research.

[12]  A. Pack,et al.  Practice parameters for the use of portable monitoring devices in the investigation of suspected obstructive sleep apnea in adults. , 2003, Sleep.

[13]  Amandine Leroux,et al.  The sleep/wake state scoring from mandible movement signal , 2012, Sleep and Breathing.

[14]  S D Ross,et al.  Systematic review and meta-analysis of the literature regarding the diagnosis of sleep apnea. , 2000, Sleep.

[15]  Sunita Ghosh,et al.  Outcomes of home-based diagnosis and treatment of obstructive sleep apnea. , 2010, Chest.

[16]  F. Abboud,et al.  Sympathetic neural mechanisms in obstructive sleep apnea. , 1995, The Journal of clinical investigation.

[17]  Jose R. Rodriguez,et al.  Utility of oxygen saturation and heart rate spectral analysis obtained from pulse oximetric recordings in the diagnosis of sleep apnea syndrome. , 2003, Chest.

[18]  P Lavie,et al.  Periodic, profound peripheral vasoconstriction--a new marker of obstructive sleep apnea. , 1999, Sleep.

[19]  W. M. Anderson,et al.  Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. , 2007, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[20]  B. Feige,et al.  Verarbeitung schlafbezogener Stimuli , 2009 .

[21]  Kai Spiegelhalder,et al.  Unterschiede in der Verarbeitung schlafbezogener Stimuli zwischen Personen mit gesundem und gestźrtem Schlaf [Differences in the processing of sleep-related stimuli between good and bad sleepers]. , 2009 .

[22]  Parmjit Singh,et al.  The new AASM criteria for scoring hypopneas: impact on the apnea hypopnea index. , 2009, Sleep.

[23]  Itsik Dvir,et al.  Evaluation of a portable device based on peripheral arterial tone for unattended home sleep studies. , 2003, Chest.

[24]  S. Connolly,et al.  CYCLICAL VARIATION OF THE HEART RATE IN SLEEP APNOEA SYNDROME Mechanisms, and Usefulness of 24 h Electrocardiography as a Screening Technique , 1984, The Lancet.

[25]  E. Wolpert A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. , 1969 .

[26]  Thomas Penzel,et al.  Peripheral arterial tonometry, oximetry and actigraphy for ambulatory recording of sleep apnea. , 2004, Physiological measurement.

[27]  Thomas Penzel,et al.  ECG signal analysis for the assessment of sleep-disordered breathing and sleep pattern , 2011, Medical & Biological Engineering & Computing.

[28]  P Lavie,et al.  Evidence for fractal correlation properties in variations of peripheral arterial tone during REM sleep. , 2002, American journal of physiology. Heart and circulatory physiology.

[29]  A. Murray,et al.  Systematic comparison of different algorithms for apnoea detection based on electrocardiogram recordings , 2002, Medical and Biological Engineering and Computing.

[30]  M. Badr,et al.  Research Priorities in Ambulatory Management of Adults with Obstructive Sleep Apnea , 2011 .

[31]  W. Whitelaw,et al.  Diagnosis of sleep apnoea: some critical issues. , 2010, The Indian journal of medical research.

[32]  Frédéric Senny,et al.  Midsagittal Jaw Movements as a Sleep/Wake Marker , 2009, IEEE Transactions on Biomedical Engineering.

[33]  Kai Spiegelhalder,et al.  Processing of sleep-related stimuli: Differences between good and poor sleepers , 2009 .

[34]  Prediction of cardiovascular risk from peripheral pulse wave , 2009 .

[35]  S. Chokroverty,et al.  The visual scoring of sleep in adults. , 2007, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[36]  G Parati,et al.  Management of obstructive sleep apnea in Europe. , 2011, Sleep medicine.

[37]  Frédéric Senny,et al.  Midsagittal Jaw Movement Analysis for the Scoring of Sleep Apneas and Hypopneas , 2008, IEEE Transactions on Biomedical Engineering.

[38]  Azadeh Yadollahi,et al.  Acoustic obstructive sleep apnea detection , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[39]  Thomas Penzel,et al.  Sleep Apnea Screening by Autoregressive Models From a Single ECG Lead , 2009, IEEE Transactions on Biomedical Engineering.

[40]  Conor Heneghan,et al.  Electrocardiogram recording as a screening tool for sleep disordered breathing. , 2008, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[41]  G. Moody,et al.  Clinical Validation of the ECG-Derived Respiration (EDR) Technique , 2008 .

[42]  David Gozal,et al.  The scoring of respiratory events in sleep: reliability and validity. , 2007, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[43]  C. Heneghan,et al.  Multimodal detection of sleep apnoea using electrocardiogram and oximetry signals , 2009, Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences.

[44]  Conrad Iber,et al.  The scoring of cardiac events during sleep. , 2007, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[45]  A. Pack Sleep medicine: strategies for change. , 2011, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[46]  M. Ouayoun,et al.  Obstructive sleep apnoea syndrome: Comparison between polysomnography and portable sleep monitoring based on jaw recordings , 2011, Neurophysiologie Clinique/Clinical Neurophysiology.

[47]  N. Collop,et al.  Portable monitoring for the diagnosis of obstructive sleep apnea , 2008, Current opinion in pulmonary medicine.

[48]  Martin Reite,et al.  ASDA standards of practice: Practice parameters for the use of portable recording in the assessment of obstructive sleep apnea , 1994 .

[49]  N. Butkov,et al.  Digital analysis and technical specifications. , 2007, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[50]  P. Houck,et al.  Evaluation of a single-channel portable monitor for the diagnosis of obstructive sleep apnea. , 2011, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[51]  Yi Wang,et al.  Diagnostic performance of single airflow channel recording (ApneaLink) in home diagnosis of sleep apnea , 2010, Sleep and Breathing.

[52]  R. Kimoff To treat or not to treat: can a portable monitor reliably guide decision-making in sleep apnea? , 2011, American journal of respiratory and critical care medicine.

[53]  A. Rechtschaffen A manual of standardized terminology, techniques and scoring system for sleep of human subjects , 1968 .