Detection of obstructive sleep apnoea by an electronic nose

Diagnosis of obstructive sleep apnoea syndrome (OSAS) is technically demanding, cost-intensive and time-consuming. The measurement of volatile organic compounds by an electronic nose is an innovative method that determines distinct molecular patterns of exhaled breath in different patient groups. We addressed the following questions: What is the diagnostic accuracy of an electronic nose in the detection of OSAS and the ability to detect effects of standard therapy in patients with OSAS? Are these results related to changes in distinct markers of airway inflammation and extracellular remodelling? We included 40 OSAS patients and 20 healthy controls. Exhaled breath of all participants was analysed using the Cyranose 320 electronic nose. Pharyngeal washings were performed to sample the upper airway compartment. For statistical analysis linear discriminant analysis was employed. We identified a linear discriminant function separating OSAS from control (p<0.0001). The corresponding area under the receiver-operating curve was 0.85 (95% CI 0.75–0.96; sensitivity 0.93 and specificity 0.7). In pharyngeal washing fluids of OSAS patients, we observed higher levels of &agr;1-antitrypsin and markers of extracellular remodelling compared to controls. The electronic nose can distinguish between OSAS patients and controls with high accuracy.

[1]  J. Gea,et al.  Early diagnosis of acute myocardial infarction in patients with pre-existing coronary artery disease using more sensitive cardiac troponin assays. , 2012, European heart journal.

[2]  C. Vogelmeier,et al.  Alpha-1 antitrypsin is elevated in exhaled breath condensate and serum in exacerbated COPD patients. , 2012, Respiratory medicine.

[3]  T. Greulich,et al.  Comparison of Two Devices and Two Breathing Patterns for Exhaled Breath Condensate Sampling , 2011, PloS one.

[4]  Prabhakaran Gopalakrishnan,et al.  Obstructive Sleep Apnea and Cardiovascular Disease , 2011, Cardiology in review.

[5]  T. Greulich,et al.  Discrimination between COPD patients with and without alpha 1‐antitrypsin deficiency using an electronic nose , 2011, Respirology.

[6]  C. Vogelmeier,et al.  The discovery of α1-antitrypsin and its role in health and disease. , 2011, Respiratory medicine.

[7]  Alphus D. Wilson,et al.  Advances in Electronic-Nose Technologies Developed for Biomedical Applications , 2011, Sensors.

[8]  U. Abeyratne,et al.  Multi-feature snore sound analysis in obstructive sleep apnea-hypopnea syndrome. , 2011, Physiological measurement.

[9]  R. Çubuk,et al.  Bronchial hyperreactivity and airway wall thickening in obstructive sleep apnea patients , 2011, Sleep and Breathing.

[10]  A. Spanevello,et al.  Systemic and airway inflammation in sleep apnea and obesity: the role of ICAM-1 and IL-8. , 2010, Translational research : the journal of laboratory and clinical medicine.

[11]  Niki Fens,et al.  Exhaled breath profiling enables discrimination of chronic obstructive pulmonary disease and asthma. , 2009, American journal of respiratory and critical care medicine.

[12]  T. Honda,et al.  A novel device (SD‐101) with high accuracy for screening sleep apnoea‐hypopnoea syndrome , 2009, Respirology.

[13]  C. Vogelmeier,et al.  Acute and Chronic Effects of Smoking on Inflammation Markers in Exhaled Breath Condensate in Current Smokers , 2009, Respiration.

[14]  K. Rabe,et al.  Comparison of exhaled breath condensate pH using two commercially available devices in healthy controls, asthma and COPD patients , 2009, Respiratory research.

[15]  Tom Fearn,et al.  Chemometric Space: Sensitivity and specificity , 2009 .

[16]  P Lavie,et al.  Molecular mechanisms of cardiovascular disease in OSAHS: the oxidative stress link , 2009, European Respiratory Journal.

[17]  Onofrio Resta,et al.  An electronic nose in the discrimination of patients with non-small cell lung cancer and COPD. , 2009, Lung cancer.

[18]  S. Cerutti,et al.  Automatic screening of obstructive sleep apnea from the ECG based on empirical mode decomposition and wavelet analysis , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[19]  C. Vogelmeier,et al.  Suppression of pulmonary innate host defence in smokers , 2008, Thorax.

[20]  Peter J Sterk,et al.  An electronic nose in the discrimination of patients with asthma and controls. , 2007, The Journal of allergy and clinical immunology.

[21]  J. Bousquet,et al.  Noninvasive methods for the detection of upper and lower airway inflammation in atopic children. , 2006, The Journal of allergy and clinical immunology.

[22]  I. Harman-boehm,et al.  Nasopharyngeal versus Oropharyngeal Sampling for Isolation of Potential Respiratory Pathogens in Adults , 2006, Journal of Clinical Microbiology.

[23]  M. Keefe.  Increased Levels and Activity of Matrix Metalloproteinase-9 in Obstructive Sleep Apnea SyndromeTazaki T, Minoguchi K, Yokoe T, et al (Showa Univ, Tokyo) Am J Respir Crit Care Med 170:1354–1359, 2004§ , 2006 .

[24]  Terry Young,et al.  Association of sleep-disordered breathing and the occurrence of stroke. , 2005, American journal of respiratory and critical care medicine.

[25]  Erica R Thaler,et al.  Medical applications of electronic nose technology , 2005, Expert review of medical devices.

[26]  Erica R Thaler,et al.  Correlation of Pneumonia Score with Electronic Nose Signature: A Prospective Study , 2005, The Annals of otology, rhinology, and laryngology.

[27]  P. Mazzone,et al.  Detection of lung cancer by sensor array analyses of exhaled breath. , 2005, American journal of respiratory and critical care medicine.

[28]  M. Littner,et al.  Practice parameters for the indications for polysomnography and related procedures: an update for 2005. , 2005, Sleep.

[29]  Philipp Lirk,et al.  Mass spectrometric profile of exhaled breath—field study by PTR-MS , 2005, Respiratory Physiology & Neurobiology.

[30]  R. Bone,et al.  The Discovery , 2005, Molecular and Cellular Biochemistry.

[31]  M. Adachi,et al.  Increased levels and activity of matrix metalloproteinase-9 in obstructive sleep apnea syndrome. , 2004, American journal of respiratory and critical care medicine.

[32]  N. Lewis.  Comparisons Between Mammalian and Artificial Olfaction Based on Arrays of Carbon Black—Polymer Composite Vapor Detectors , 2004 .

[33]  Qutayba Hamid,et al.  Upper airway muscle inflammation and denervation changes in obstructive sleep apnea. , 2004, American journal of respiratory and critical care medicine.

[34]  J. Gardner,et al.  Clinical evaluation of the electronic nose in the diagnosis of ear, nose and throat infection: a preliminary study. , 2004, The Journal of laryngology and otology.

[35]  Onofrio Resta,et al.  8-Isoprostane, a marker of oxidative stress, is increased in exhaled breath condensate of patients with obstructive sleep apnea after night and is reduced by continuous positive airway pressure therapy. , 2003, Chest.

[36]  S. Zahler,et al.  An angiogenic role for the human peptide antibiotic LL-37/hCAP-18. , 2003, The Journal of clinical investigation.

[37]  Johannes B Reitsma,et al.  The STARD initiative , 2003, The Lancet.

[38]  K. Chung,et al.  Matrix metalloproteinase-9 expression in asthma: effect of asthma severity, allergen challenge, and inhaled corticosteroids. , 2002, Chest.

[39]  K. Bloch,et al.  German Version of the Epworth Sleepiness Scale , 1999, Respiration.

[40]  T S Eligulashvili,et al.  [Sleep apnea syndrome]. , 1997, Klinicheskaia meditsina.

[41]  D. Altman,et al.  Statistics Notes: Diagnostic tests 1: sensitivity and specificity , 1994 .

[42]  T. Young,et al.  The occurrence of sleep-disordered breathing among middle-aged adults. , 1993, The New England journal of medicine.

[43]  J. Stradling,et al.  Neck circumference and other clinical features in the diagnosis of the obstructive sleep apnoea syndrome. , 1992, Thorax.

[44]  A. Williams,et al.  Screening for sleep apnea using pulse oximetry and a clinical score. , 1991, Chest.

[45]  P. E. Haavik.  Sleep apnoea syndrome , 1983, Canadian Anaesthetists' Society journal.

[46]  W. Youden,et al.  Index for rating diagnostic tests , 1950, Cancer.