Digital monitoring of sleep-disordered breathing using snoring sound and arterial oxygen saturation.

A new portable digital recorder (SNORESAT) that uses the sound of snoring and arterial oxygen saturation (SaO2) to monitor breathing abnormalities during sleep was constructed and compared in the laboratory with standard overnight polysomnography (PSG). The device digitally records sound from a transducer applied to the chest and SaO2 from a commercially available ear oximeter. A snore is identified when the moving time average of the sound exceeds a threshold voltage level longer than 0.26 s. The stored data are transferred to a personal computer for poststudy analysis. An analysis algorithm identifies a respiratory disturbance event when a quiet period of 10 to 120 s separates two snores and is associated with a fall in SaO2 exceeding 3%. The respiratory disturbance index (RDI), mean apnea duration, mean lowest SaO2, and number of desaturations > 3% are computed. A total of 129 referrals to the sleep apnea outpatient clinic underwent simultaneous all-night recording of PSG and SNORESAT. Using the computed RDI recorded by the SNORESAT, the sensitivity and specificity of the monitor in detecting sleep apnea syndrome (SAS) ranged between 84 and 90% and 95 and 98%, respectively, depending on the PSG value of RDI used to define SAS (range, > or = 7 to > or = 20 events/h). Using a PSG value of RDI > or = 10, or > or = 20 RD/h as the definition for SAS, the prevalence of SAS in the referral population was 45 and 31%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[1]  E. Sforza,et al.  Pulmonary hypertension, hypoxemia, and hypercapnia in obstructive sleep apnea patients. , 1989, Chest.

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

[3]  S. Redline,et al.  Measurement of sleep-related breathing disturbances in epidemiologic studies. Assessment of the validity and reproducibility of a portable monitoring device. , 1991, Chest.

[4]  L. Findley,et al.  Automobile accidents involving patients with obstructive sleep apnea. , 1988, The American review of respiratory disease.

[5]  D. Crowell,et al.  Identifying sleep apnea from self-reports. , 1988, Sleep.

[6]  P. Lavie,et al.  Incidence of sleep apnea in a presumably healthy working population: a significant relationship with excessive daytime sleepiness. , 1983, Sleep.

[7]  M J Hensley,et al.  A comparison of clinical assessment and home oximetry in the diagnosis of obstructive sleep apnea. , 1993, The American review of respiratory disease.

[8]  R. Rogers,et al.  The detection of sleep apnea in the awake patient. The 'saw-tooth' sign. , 1981, JAMA.

[9]  M Partinen,et al.  Daytime sleepiness and vascular morbidity at seven-year follow-up in obstructive sleep apnea patients. , 1990, Chest.

[10]  D. Sackett,et al.  The Ends of Human Life: Medical Ethics in a Liberal Polity , 1992, Annals of Internal Medicine.

[11]  M. Kryger,et al.  Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. , 1988, Chest.

[12]  A. Taube,et al.  Prevalence of sleep apnea syndrome among Swedish men--an epidemiological study. , 1988, Journal of clinical epidemiology.

[13]  D. Hillman,et al.  Association of sleep apnoea with myocardial infarction in men , 1990, The Lancet.

[14]  B. Rappaport,et al.  Verification of Sleep Apnea Using a Portable Sleep Apnea Screening Device , 1990, Southern medical journal.

[15]  E. Svanborg,et al.  A limited diagnostic investigation for obstructive sleep apnea syndrome. Oximetry and static charge sensitive bed. , 1990, Chest.

[16]  C. Guilleminault,et al.  Investigations of an automatic screening device (MESAM) for obstructive sleep apnoea. , 1990, The European respiratory journal.

[17]  N. Douglas,et al.  Clinical value of polysomnography , 1992, The Lancet.

[18]  J. Sassin,et al.  Flow-volume curves reflect pharyngeal airway abnormalities in sleep apnea syndrome. , 1983, The American review of respiratory disease.

[19]  Stanton A. Glantz,et al.  Primer of biostatistics : statistical software program version 6.0 , 1981 .