The LifeShirt

An accurate ambulatory breathing monitor is needed to observe acute respiratory changes in patients with medical or psychological disorders outside the clinic (e.g., hyperventilation during panic or apneas during sleep). Significant limitations of existing monitors are size, troublesome operation, and difficulty holding chest and abdomen bands in place during 24-hour recordings. Recently, a garment has been developed with embedded inductive plethysmography sensors for continuous ambulatory monitoring of respiration, heart activity, inductive cardiography, motility, postural changes, and other functions. The signals are displayed and stored on a handheld computer (Visor), and then analyzed offline, extracting more than 40 clinical parameters relating to cardiorespiratory function (e.g., heart rate, respiratory sinus arrhythmia, tidal volume, stroke volume, pre-ejection period, apnea-hypopnea index, thoraco-abdominal coordination, sighing). The device also serves as an electronic diary of symptoms, moods, and activities. This advanced system may open a new era in ambulatory monitoring for clinical practice and scientific research.

[1]  J. Stradling,et al.  Autonomic markers of arousal during sleep in patients undergoing investigation for obstructive sleep apnoea, their relationship to EEG arousals, respiratory events and subjective sleepiness , 1998, Journal of sleep research.

[2]  M. Sackner,et al.  Validation of respiratory inductive plethysmography using different calibration procedures. , 2015, The American review of respiratory disease.

[3]  M A Sackner,et al.  Thoracocardiography. Part 1: Noninvasive measurement of changes in stroke volume comparisons to thermodilution. , 1991, Chest.

[4]  J. Saul,et al.  Transfer function analysis of the circulation: unique insights into cardiovascular regulation. , 1991, The American journal of physiology.

[5]  M. Stein,et al.  Irregular breathing during sleep in patients with panic disorder. , 1995, The American journal of psychiatry.

[6]  A. Pack,et al.  Ventilation during early and late rapid-eye-movement sleep in normal humans. , 1991, Journal of applied physiology.

[7]  W. Roth,et al.  Slow Recovery From Voluntary Hyperventilation in Panic Disorder , 2001, Psychosomatic medicine.

[8]  W. Roth,et al.  Acute and delayed effects of alprazolam on flight phobics during exposure. , 1997, Behaviour research and therapy.

[9]  W. Roth,et al.  Respiratory Dysregulation in Anxiety, Functional Cardiac, and Pain Disorders , 2001, Behavior modification.

[10]  J. Gorman,et al.  Ambulatory monitoring of respiration in anxiety. , 1996, Anxiety.

[11]  M J Tobin,et al.  Accuracy of the respiratory inductive plethysmograph during loaded breathing. , 1987, Journal of applied physiology.

[12]  M A Sackner,et al.  Accuracy of respiratory inductive plethysmographic cross-sectional areas. , 1988, Journal of applied physiology.

[13]  Georg W. Alpers,et al.  Respiratory pathophysiology of clinical anxiety outside the laboratory: Assessment of end tidal pCO2, respiratory pattern variability, and transfer function RSA , 2001 .

[14]  M A Sackner,et al.  Measurement of breath amplitudes: Comparison of three noninvasive respiratory monitors to integrated pneumotachograph , 1993, Pediatric pulmonology.

[15]  W. Roth,et al.  Respiratory Biofeedback-Assisted Therapy in Panic Disorder , 2001, Behavior modification.

[16]  M A Sackner,et al.  Inductance cardiography (thoracocardiography): a novel, noninvasive technique for monitoring left ventricular filling. , 1999, Journal of critical care.

[17]  L. Johnson,et al.  Volume Ejected in Early Systole: A Sensitive Index of Left Ventricular Performance in Coronary Artery Disease , 1975, Circulation.

[18]  W. Roth,et al.  Characteristics of sighing in panic disorder , 2001, Biological Psychiatry.

[19]  D. Klein False suffocation alarms, spontaneous panics, and related conditions. An integrative hypothesis. , 1993, Archives of general psychiatry.

[20]  J. Blumenthal,et al.  Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. , 1999, Circulation.

[21]  W. Roth,et al.  The somatic symptom paradox in DSM-IV anxiety disorders: suggestions for a clinical focus in psychophysiology , 2001, Biological Psychology.

[22]  Frank H Wilhelm,et al.  Using minute ventilation for ambulatory estimation of additional heart rate , 1998, Biological Psychology.

[23]  J. Haythornthwaite,et al.  Ambulatory monitoring of respiration: inhibitory breathing in the natural environment. , 1992, Psychophysiology.

[24]  C. Wientjes,et al.  A comparison of three quantification methods for estimation of respiratory sinus arrhythmia. , 1990, Psychophysiology.

[25]  F. H. Wilhelm,et al.  Ambulatory assessment of clinical anxiety , 1996 .

[26]  E. Russi,et al.  Noninvasive monitoring of cardiac output in critically ill patients with thoracocardiography. , 1997, American journal of respiratory and critical care medicine.

[27]  W. Roth,et al.  Taking the laboratory to the skies: ambulatory assessment of self-report, autonomic, and respiratory responses in flying phobia. , 1998, Psychophysiology.

[28]  M. Sackner,et al.  Thoracocardiographic-derived left ventricular systolic time intervals. , 1994, Chest.

[29]  W. Roth,et al.  Voluntary Breath Holding in Panic and Generalized Anxiety Disorders , 1998, Psychosomatic medicine.

[30]  A Steptoe,et al.  Pulse wave velocity and blood pressure change: calibration and applications. , 1976, Psychophysiology.

[31]  J. Mead,et al.  Measurement of the separate volume changes of rib cage and abdomen during breathing. , 1967, Journal of applied physiology.

[32]  M A Sackner,et al.  Validation of respiratory inductive plethysmography in patients with pulmonary disease. , 1983, Chest.

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

[34]  J. Fahrenberg,et al.  Ambulatory assessment : computer-assisted psychological and psychophysiological methods in monitoring and field studies , 1999 .

[35]  Wise Mg,et al.  Anxiety and mood disorders in medically ill patients. , 1990 .

[36]  R. Maddock,et al.  Panic disorder and chest pain: a study of cardiac stress scintigraphy patients. , 1994, The American journal of cardiology.

[37]  W. Roth,et al.  Physiologic instability in panic disorder and generalized anxiety disorder , 2001, Biological Psychiatry.

[38]  B. Krieger,et al.  Calibration of respiratory inductive plethysmograph during natural breathing. , 1989, Journal of applied physiology.

[39]  W. Roth,et al.  Analysis of cardiovascular regulation. , 1999, Biomedical sciences instrumentation.

[40]  A. Rechtschaffen,et al.  A manual of standardized terminology, technique and scoring system for sleep stages of human subjects , 1968 .

[41]  P. Grossman,et al.  Prediction of tonic parasympathetic cardiac control using respiratory sinus arrhythmia: the need for respiratory control. , 1991, Psychophysiology.

[42]  J M Kinney,et al.  Effects of respiratory apparatus on breathing pattern. , 1980, Journal of applied physiology: respiratory, environmental and exercise physiology.

[43]  S. Loring,et al.  A simple and reliable method to calibrate respiratory magnetometers and Respitrace. , 1995, Journal of applied physiology.

[44]  J. Fahrenberg,et al.  Progress in Ambulatory Assessment , 2001 .

[45]  R. Bonsall,et al.  Ischemic, hemodynamic, and neurohormonal responses to mental and exercise stress. Experience from the Psychophysiological Investigations of Myocardial Ischemia Study (PIMI). , 1996, Circulation.

[46]  Frank H Wilhelm,et al.  Trusting computerized data reduction too much: a critique of Anderson's ambulatory respiratory monitor , 1998, Biological Psychology.

[47]  M A Sackner,et al.  Measurement of systolic time intervals during exercise using inductive plethysmography , 1984, International journal of clinical monitoring and computing.