scholarly journals Lack of night-to-night variability of sleep-disordered breathing measured during home monitoring

2003 ◽  
Vol 82 (2) ◽  
pp. 135-138 ◽  
Author(s):  
Terence M. Davidson ◽  
Philip Gehrman ◽  
Henry Ferreyra
Keyword(s):  
Sleep Disordered Breathing ◽  
Home Monitoring ◽  
Objective Measure ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Significant Change ◽  
Home Sleep Study ◽  
Important Objective ◽  
Disordered Breathing

The apnea-hypopnea index (AHI) is an important objective measure used in the diagnosis of sleep-disordered breathing. In affected patients, the AHI has been reported to vary across successive nights. We conducted a multichannel home sleep study on 44 patients with sleep-disordered breathing to determine whether the AHI does indeed vary and, if so, to quantify the degree of night-to-night variability. Of this group, 23 patients were tested for 3 consecutive nights and 21 were tested for 2 consecutive nights. Among the group as a whole, we found no statistically significant change in AHI across nights, although we did identify variations among individual patients.

scholarly journals Sleep Disordered Breathing Measures in Early Pregnancy Are Associated with Depressive Symptoms in Late Pregnancy

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 858
Author(s):  
Margaret H. Bublitz ◽  
Meghan Sharp ◽  
Taylor Freeburg ◽  
Laura Sanapo ◽  
Nicole R. Nugent ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Early Pregnancy ◽  
Sleep Disordered Breathing ◽  
Late Pregnancy ◽  
Self Report ◽  
Apnea Hypopnea Index ◽  
Berlin Questionnaire ◽  
Sleep Study ◽  
Home Sleep Study ◽  
Disordered Breathing

Sleep disordered breathing (SDB) and depression are both common complications of pregnancy and increase risk for adverse maternal and neonatal outcomes. SDB precedes onset of depression in non-pregnant adults; however, the longitudinal relationship has not been studied in pregnancy. The present research examined temporal associations between SDB and depressive symptoms in 175 pregnant women at risk for SDB (based on frequent snoring and obesity), but without an apnea hypopnea index of ≥5 events per hour at enrollment. Women completed a self-report assessments of depressive symptoms using PHQ-9 and in-home level III sleep apnea monitoring at approximately 12- and 32-weeks’ gestation. We also assessed the risk for SDB using the Berlin Questionnaire in early pregnancy. Results revealed that measures of SDB in early pregnancy as assessed by in-home sleep study, but not by self-reported SDB, predicted elevated depressive symptoms in late pregnancy. SDB in late pregnancy was not associated with depressive symptoms. To conclude, these findings suggest that SDB may increase the risk for elevated depressive symptoms as pregnancy progresses.

Abstract 11556: Association of Sleep Disordered Breathing and ECG R-Wave to Radial Artery Pulse Delay: The MESA Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Younghoon Kwon ◽  
David R Jacobs ◽  
Pamela L Lutsey ◽  
Peter Hannan ◽  
Julio A Chirinos ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Radial Artery ◽  
Sleep Disordered Breathing ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Ventricular Ejection Fraction ◽  
Pulse Delay ◽  
Disordered Breathing

Background: Arterial stiffness is a well-recognized predictor of cardiovascular disease (CVD). ECG R-wave to Radial artery pulse delay (RRD) is a novel hemodynamic index in which arterial stiffness is an important component (shorter delay = Higher arterial stiffness) and is obtainable from a single tonometric measurement at the radial artery with simultaneous ECG. Sleep disordered breathing (SDB) has emerged as a risk factor for CVD. The aim of the study was to determine the association of SDB with RRD. Methods: Multi-Ethnic Study of Atherosclerosis participants in 2010-2012 without overt CVD who underwent a sleep study, radial artery tonometry and cardiac MRI were eligible for this cross-sectional analysis (N = 1173, Mean [SD] age: 67.8 ± 8.8, Women: 55.4%). Independent associations between SDB indices including apnea hypopnea index (AHI) and oxygen (O2) desaturation index (ODI: events with more than 4% O2 desaturation), and RRD (transit time in msec) were examined. Model was constructed to adjust for isovolumetric contraction time, another component of RRD, by including measures of contractility and preload (left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVEDV) respectively). Results: Median [IQR] of AHI and ODI were 7.9/hr [2.9- 18.0] and 7.5/hr [3.0- 17.5] respectively. Adjusting for transit path length, demographic factors, BMI and CVD risk factors, both AHI and ODI were inversely associated with RRD (β= -50.3 msec per SD, p = 0.09 and β= -0.60.2 msec per SD, p = 0.04 respectively). In gender stratified analyses given presence of significant interaction, measures of SDB were predictive of RRD only in men. No significant associations were found with key nocturnal hypoxemia indices including mean O2 saturation (SpO2), percent time with SpO2less than 90 % and minimum SpO2. Men, older age, Asian race, high blood pressure, LVEF and LVEDV were also inversely associated with RRD. Conclusion: SDB was associated with shorter RRD implying higher arterial stiffness in men only. These findings suggest the importance of apnea related dynamic change in SpO2 (intermittent hypoxia and reoxygenation) in its potential link to arterial stiffness and also highlights effect modification by gender in the association between the two.

scholarly journals The Utility of a Portable Sleep Monitor to Diagnose Sleep-Disordered Breathing in a Pediatric Population

2014 ◽  
Vol 21 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Colin Massicotte ◽  
Suhail Al-Saleh ◽  
Manisha Witmans ◽  
Indra Narang
Keyword(s):  
Sleep Disordered Breathing ◽  
Pediatric Population ◽  
Apnea Hypopnea Index ◽  
Strongly Correlated ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Abnormal Breathing ◽  
Delays In Diagnosis ◽  
Pearson Correlations ◽  
Disordered Breathing

BACKGROUND: Central and/or obstructive sleep-disordered breathing (SDB) in children represents a spectrum of abnormal breathing during sleep. SDB is diagnosed using the gold standard, overnight polysomnography (PSG). The limited availability and access to PSG prevents its widespread use, resulting in significant delays in diagnosis and treatment of SDB. As such, portable sleep monitors are urgently needed.OBJECTIVE: To evaluate the utility of a commercially available portable sleep study monitor (PSS-AL) (ApneaLink, ResMed, USA) to diagnose SDB in children.METHODS: Children referred to a pediatric sleep facility were simultaneously monitored using the PSS-AL monitor and overnight PSG. The apnea-hypopnea index (AHI) was calculated using the manual and autoscoring function of the PSS-AL, and PSG. Sensitivity and specificity were compared with the manually scored PSS-AL and PSG. Pearson correlations and Bland-Altman plots were constructed.RESULTS: Thirty-five children (13 female) completed the study. The median age was 11.0 years and the median body mass index z-score was 0.67 (range −2.3 to 3.8). SDB was diagnosed in 17 of 35 (49%) subjects using PSG. The AHI obtained by manually scored PSS-AL strongly correlated with the AHI obtained using PSG (r=0.89; P<0.001). Using the manually scored PSS-AL, a cut-off of AHI of >5 events/h had a sensitivity of 94% and a specificity of 61% to detect any SDB diagnosed by PSG.CONCLUSIONS: Although PSG is still recommended for the diagnosis of SDB, the ApneaLink sleep monitor has a role for triaging children referred for evaluation of SDB, but has limited ability to determine the nature of the SDB.

scholarly journals 0458 Does Simulated Limited-Channel Home Sleep Study Testing Accurately Predict The Diagnosis Of Sleep-disordered Breathing In Patients With Spinal Cord Injury, Or Disease?

SLEEP ◽  
2019 ◽  
Vol 42 (Supplement_1) ◽  
pp. A184-A184
Author(s):  
Salam Zeineddine ◽  
Kelsey Arvai ◽  
Sarah E Vaughan ◽  
Anan Salloum ◽  
Jennifer L Martin ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Sleep Disordered Breathing ◽  
Sleep Study ◽  
Cord Injury ◽  
Home Sleep Study ◽  
Disordered Breathing

Abstract 11254: Association of Sleep Disordered Breathing and Sleep Architecture With Atrial Fibrillation: The MESA Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Younghoon Kwon ◽  
Sina A Gharib ◽  
Mary Lou Biggs ◽  
David R Jacobs ◽  
Alvaro Alonso ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Disordered Breathing ◽  
Slow Wave Sleep ◽  
Cross Sectional Study ◽  
Sleep Architecture ◽  
Apnea Hypopnea Index ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Sleep Study ◽  
Disordered Breathing

Background: Sleep disordered breathing (SDB) has been associated with nocturnal atrial fibrillation (AF). However, the association of SDB and other important sleep characteristics with prevalent AF (beyond nocturnal AF) is unclear. We explored the cross-sectional association of SDB and other objectively measured sleep characteristics with AF. Methods: Prevalence of AF was examined among MESA (Multi-Ethnic Study of Atherosclerosis) study participants who underwent polysomnography (PSG) (n=2048) (MESA Sleep Study). Presence or a history of AF was determined if AF or atrial flutter was identified by at least one of the following measures: (i) 12-lead ECG during study examination; (ii) PSG; (iii) ICD-9 codes from hospital discharge diagnosis; (IV) inpatient and outpatient Medicare claims data. Results: Overall prevalence of AF was 4.9 % (n=100). Prevalence of AF was significantly higher at 6.7% in subjects with moderate to severe SDB (n = 691, apnea hypopnea index (AHI) ≥15/h) compared with a prevalence of 4.0% in participants without SDB (n = 707, AHI < 5/h) (p=0.02). After accounting for demographics, body habitus, cardiovascular disease (CVD) risk factors and prevalent CVD, participants with higher values of AHI were more likely to have AF, although the result was not statistically significant (OR: 1.22 [0.99-1.49] per SD [17/hr], p = 0.06). Exploratory analyses of the association of sleep architecture with AF using the same model found significantly lower odds of AF associated with longer duration of slow wave sleep (SWS) (OR: 0.66 [0.5-0.89] per SD [34 min], p = 0.01). Results from a multivariable model that included 3 key sleep characteristics (AHI, SWS time and arousal index (AI)) suggested that all were independently associated with AF (AHI: OR 1.45 [1.13-1.87] per SD, p = 0.004; SWS time: OR 0.65 [0.49-0.87] per SD, p = 0.004; AI: OR 0.65 [0.50-0.86] per SD (12/hr), p = 0.002). Conclusion: In a cross-sectional study of a large multi-ethnic population, the prevalence of AF was associated with more severe SDB, shorter SWS time, and lower AI. This finding highlights sleep architecture’s implication, potentially via autonomic balance, in the association between sleep and AF.

scholarly journals 0968 Sleep-disordered Breathing In Schaaf-yang Syndrome

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A367-A368
Author(s):  
W Powell ◽  
M Rech ◽  
C Schaaf ◽  
J Wrede
Keyword(s):  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Central Sleep Apnea ◽  
Sleep Time ◽  
Sleep Stages ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Central Index ◽  
Obstructive Sleep ◽  
Disordered Breathing

Abstract Introduction Schaaf-Yang Syndrome (SYS) is a genetic disorder caused by truncating variants in the MAGEL2 gene located in the maternally imprinted, paternally expressed Prader-Willi syndrome (PWS) region at 15q11-13. The SYS phenotype shares features with PWS, a disorder with known high incidence of central and obstructive sleep apnea (OSA). However the spectrum of sleep-disordered breathing in SYS has not been described. Methods We performed a retrospective analysis of polysomnograms from 22 of the known 115 patients with molecular diagnosis of SYS. Sleep characteristics including total sleep time, latency, efficiency, % sleep stages, apnea-hypopnea index (AHI), obstructive index, central index, and oxygenation were analyzed for the whole group and by truncation location (c.1996dupC variants [n=11] or other locations [n=11]). Only the initial diagnostic study or initial diagnostic portion of a split-night study was used in analysis (analytic n=21). Results We collected 33 sleep study reports from 22 patients, ages 2 months - 18.5 years. Mean analyzed sleep time was 357 minutes (129-589 min) with mean sleep efficiency of 71.45% (45-94%) and sleep latency of 24.8 minutes (0-146 min). The mean apnea-hypopnea index (AHI) was 19.1/hr (0.9 -49/hr) with mean obstructive AHI of 16.3 (0.6-49/hr). Mean central index was 2.8/hr (0-14/hr). 18/21 (86%) were diagnosed with OSA, and 13/21 (62%) with moderate or severe OSA (oAHI &gt;5/hr). Central sleep apnea was diagnosed in 2/21 (9.5%). 15 studies reported periodic limb movement index (PLMI) with mean of 7.8 (0-67/hr) and 4/15 (26%) with PLMI &gt;5. Comparison of genotype groups did not reveal any difference in presence of OSA or severity of OSA. Conclusion OSA is frequently identified on polysomnography in patients with SYS. Central sleep apnea is less common, which is in contrast to PWS. The majority of patients with OSA had moderate or severe OSA, and 47% had severe OSA. Support N/A

570 Comparing NIV Adherence in Early versus Advanced Stage Sleep Disordered Breathing for Children with Neuromuscular Disease

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A225-A225
Author(s):  
Prabhjot Bedi ◽  
Guillermo Hasbun ◽  
Maria Castro-Codesal
Keyword(s):  
Neuromuscular Disease ◽  
Sleep Disordered Breathing ◽  
Muscle Tone ◽  
Respiratory Muscles ◽  
Nrem Sleep ◽  
Lower Percentage ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Disordered Breathing

Abstract Introduction Children with neuromuscular disease (NMD) typically develop progressive sleep disordered breathing (SDB), including obstructive sleep apnea (OSA), nocturnal hypoxemia and/or hypoventilation, due to loss of upper airway muscle tone and weakness of respiratory muscles. Commonly, the SDB initially presents during rapid eye movement (REM) sleep, as this stage is associated with physiological muscle atonia, but then progresses to non-REM (NREM) sleep and ultimately daytime respiratory insufficiency. Non-invasive ventilation (NIV) is currently the treatment of choice for children with NMD and SDB. However, the use of NIV in REM-related SDB is less demonstrated and adequate therapy adherence is unclear. The aim of this study is to determine differences in NIV adherence in children with early (REM) versus advanced (non-REM) SDB. Methods Children (0–18 years) diagnosed with NMD and using NIV for the past 10 years were included. Demographic, clinical, technology-related, and sleep study data were collected from medical charts and polysomnography reports. Adherence data (mean hours of NIV use and % days NIV was used &gt;4hrs) were collected from NIV machine downloads. Children were categorized into two groups based on based on their apnea-hypopnea index (AHI) ratio between REM and NREM sleep. Children with REM-SDB were defined as a REM/NREM AHI ratio of ≥ 2. Children with NREM-SDB were defined as a REM/NREM AHI ratio &lt; 2. Results A total of 14 children (9 REM-SDB and 5 NREM-SDB) were included in the analysis. Both groups were comparable with respect to demographic, clinical, and technology-related characteristics. A total of 24 adherence reports were available for the cohort (16 REM-SDB and 8 NREM-SDB). The mean hours of NIV use per night was comparable between the REM-SDB and NREM-SDB groups (9.2±1.3hrs vs. 9.0±0.4hrs respectively), but the percent days NIV was used &gt;4hrs was higher in the NREM-SDB group (68.7±9.6 vs. 93.0±2.7, p=0.03). Conclusion NIV adherence was high for children with both REM-SDB and NREM-SDB. While hours of NIV use were comparable between both groups, suggesting good NIV tolerance through the night, children with REM-SDB had a lower percentage of days with NIV use &gt;4hr, suggesting less willingness to use the therapy. Support (if any):

569 Correlation between age and initial findings of sleep disordered breathing in children with achondroplasia

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A224-A225
Author(s):  
Fayruz Araji ◽  
Cephas Mujuruki ◽  
Brian Ku ◽  
Elisa Basora-Rovira ◽  
Anna Wani
Keyword(s):  
Sleep Apnea ◽  
Primary Care Physicians ◽  
Sleep Disordered Breathing ◽  
Upper Airway ◽  
Sleep Study ◽  
Surgical Interventions ◽  
Screening Guidelines ◽  
Obstructive Sleep ◽  
Children’S Sleep ◽  
Disordered Breathing

Abstract Introduction Achondroplasia (ACH) occurs approximately 1 in 20,000–30,000 live births. They are prone to sleep disordered breathing specifically due to the upper airway stenosis, enlarged head circumference, combined with hypotonia and limited chest wall size associated with scoliosis at times. The co-occurrence of sleep apnea is well established and can aide in the decision for surgical intervention, however it is unclear at what age children should be evaluated for sleep apnea. Screening is often delayed as during the daytime there is no obvious gas exchange abnormalities. Due to the rareness of this disease, large studies are not available, limiting the data for discussion and analysis to develop guidelines on ideal screening age for sleep disordered breathing in children with ACH. Methods The primary aim of this study is to ascertain the presence of sleep disorder breathing and demographics of children with ACH at time of first polysomnogram (PSG) completed at one of the largest pediatric sleep lab in the country. The secondary aim of the study is to identify whether subsequent polysomnograms were completed if surgical interventions occurred and how the studies differed over time with and without intervention. Retrospective review of the PSGs from patients with ACH, completed from 2017–2019 at the Children’s Sleep Disorders Center in Dallas, TX. Clinical data, demographics, PSG findings and occurrence of interventions were collected. Results Twenty-seven patients with the diagnosis of ACH met criteria. The average age at the time of their first diagnostic PSG was at 31.6 months of age (2.7 years), of those patients 85% had obstructive sleep apnea (OSA),51% had hypoxemia and 18% had hypercapnia by their first diagnostic sleep study. Of those with OSA, 50% were severe. Majority were females, 55%. Most of our patients were Hispanic (14%), Caucasian (9%), Asian (2%), Other (2%), Black (0%). Each patient had an average of 1.9 PSGs completed. Conclusion Our findings can help create a foundation for discussion of screening guidelines. These guidelines will serve to guide primary care physicians to direct these patients to an early diagnosis and treatment of sleep disordered breathing. Support (if any):

Sign in / Sign up

Export Citation Format

Share Document