家庭睡眠呼吸暂停监测在阻塞性睡眠呼吸暂停诊断中的应用与研究进展
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摘要
多导睡眠描记(polysomnography,PSG)是诊断阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)的金标准,但因导联众多、需要场地及专业医师介入或值守等原因缺乏可及性和经济性。家庭睡眠呼吸暂停监测(home sleep apnea testing,HSAT)凭借其简便、快捷、经济等优势,作为PSG的替代方式,正受到越来越多的关注。本文就HSAT的分类、应用范围、不同种类的可靠性和不同分析方法可能带来的差异等内容作一综述,总结了HSAT现存问题,并提出可能的解决问题的研究方向。
Polysomnography(PSG) is the gold standard test for the diagnosis of obstructive sleep apnea(OSA). However, PSG is inconvenient and uneconomical because of the large number of electrodes and sensors, the need for venues and intervention or duty of professional doctors. As a result, home sleep apnea testing(HSAT) is attracting more and more attention as an alternative to PSG, because of its simplicity, rapidness, and economy. This review introduces the classification, application scope, reliability of different types of HSAT, and possible differences caused by different analysis methods, and summarizes the existing problems and puts forward the prospect.
Polysomnography(PSG) is the gold standard test for the diagnosis of obstructive sleep apnea(OSA). However, PSG is inconvenient and uneconomical because of the large number of electrodes and sensors, the need for venues and intervention or duty of professional doctors. As a result, home sleep apnea testing(HSAT) is attracting more and more attention as an alternative to PSG, because of its simplicity, rapidness, and economy. This review introduces the classification, application scope, reliability of different types of HSAT, and possible differences caused by different analysis methods, and summarizes the existing problems and puts forward the prospect.
引文
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[15] ABUMUAMAR A M,DORIAN P,NEWMAN D,et al.A comparison of two nights of ambulatory ssleep testing in arrhythmia patients[J].Sleep Disord,2018,2018:2394146.
[16] ROMEM A,ROMEM A,KOLDOBSKIY D,et al.Diagnosis of obstructive sleep apnea using pulse oximeter derived photoplethysmographic signals[J].J Clin Sleep Med,2014,10(3):285-290.
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[19] CHEN H,LOWE A A,BAI Y,et al.Evaluation of a portable recording device (ApneaLink) for case selection of obstructive sleep apnea[J].Sleep Breath,2009,13(3):213-219.
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[21] CLAMAN D,MURR A,TROTTER K.Clinical validation of the Bedbugg in detection of obstructive sleep apnea[J].Otolaryngol Head Neck Surg,2001,125(3):227-230.
[22] ABRAHAMYAN L,SAHAKYAN Y,CHUNG S,et al.Diagnostic accuracy of level IV portable sleep monitors versus polysomnography for obstructive sleep apnea:a systematic review and meta-analysis[J].Sleep Breath,2018,22(3):593-611.
[23] LIGHT M P,CASIMIRE T N,CHUA C,et al.Addition of frontal EEG to adult home sleep apnea testing:does a more accurate determination of sleep time make a difference?[J].Sleep Breath,2018,22(4):1179-1188.
[24] CHEN K,ZHANG C,MA J,et al.Sleep staging from single-channel EEG with multi-scale feature and contextual information[J].Sleep Breath,2019.
[25] SABIL A,VANBUIS J,BAFFET G,et al.Automatic identification of sleep and wakefulness using single-channel EEG and respiratory polygraphy signals for the diagnosis of obstructive sleep apnea[J].J Sleep Res,2019,28(2):e12795.
[26] THOMAS R J,MIETUS J E,PENG C K,et al.An electrocardiogram-based technique to assess cardiopulmonary coupling during sleep[J].Sleep,2005,28(9):1151-1161.
[27] 樊蕾.心肺耦合分析技术的临床应用与研究进展[J].世界睡眠医学杂志,2017,4(3):169-174.
[28] LEE S H,CHOI J H,PARK I H,et al.Measuring sleep quality after adenotonsillectomy in pediatric sleep apnea[J].Laryngoscope,2012,122(9):2115-2121.
[29] SCHRAMM P J,THOMAS R J.Assessment of therapeutic options for mild obstructive sleep apnea using cardiopulmonary coupling measures[J].J Clin Sleep Med,2012,8(3):315-320.
[30] 谢敏,雷飞,郭丹,等.心肺耦合分析技术对阻塞性睡眠呼吸暂停的诊断价值[J].中华医学杂志,2018,98(20):1565-1569.
[31] 冯晶,吴惠涓,王宗文,等.心肺耦合技术与多导睡眠图对睡眠呼吸事件判读的一致性分析[J].中华神经科杂志,2017,50(8):606-612.
[32] AURORA R N,SWARTZ R,PUNJABI N M.Misclassification of OSA severity with automated scoring of home sleep recordings[J].Chest,2015,147(3):719-727.
[33] LABARCA G,DREYSE J,SALAS C,et al.Differences between manual and automatic analysis in determining the severity of obstructive sleep apnea using home sleep apnea testing[J].Sleep Med,2018,47:66-71.
[34] MAGALANG U J,JOHNS J N,WOOD K A,et al.Home sleep apnea testing:comparison of manual and automated scoring across international sleep centers[J].Sleep Breath,2019,23(1):25-31.
[ 2 ] KAPUR V K,AUCKLEY D H,CHOWDHURI S,et al.Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea:an American academy of sleep medicine clinical practice guideline[J].J Clin Sleep Med,2017,13(3):479-504.
[ 3 ] FERBER R,MILLMAN R,COPPOLA M,et al.Portable recording in the assessment of obstructive sleep apnea.ASDA standards of practice[J].Sleep,1994,17(4):378-392.
[ 4 ] KIM R D,KAPUR V K,REDLINE-BRUCH J,et al.An economic evaluation of home versus laboratory-based diagnosis of obstructive sleep apnea[J].Sleep,2015,38(7):1027-1037.
[ 5 ] KRISHNASWAMY U,ANEJA A,KUMAR R M,et al.Utility of portable monitoring in the diagnosis of obstructive sleep apnea[J].J Postgrad Med,2015,61(4):223-229.
[ 6 ] COLLOP N A,ANDERSON W M,BOEHLECKE B,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[J].J Clin Sleep Med,2007,3(7):737-747.
[ 7 ] WITTINE L M,OLSON E J,MORGENTHALER T I.Effect of recording duration on the diagnostic accuracy of out-of-center sleep testing for obstructive sleep apnea[J].Sleep,2014,37(5):969-975.
[ 8 ] VAT S,HABA-RUBIO J,TAFTI M,et al.Scoring criteria for portable monitor recordings:a comparison of four hypopnoea definitions in a population-based cohort[J].Thorax,2015,70(11):1047-1053.
[ 9 ] MARCUS C L,BROOKS L J,DRAPER K A,et al.Diagnosis and management of childhood obstructive sleep apnea syndrome[J].Pediatrics,2012,130(3):e714-e755.
[10] SUZUKI M,FURUKAWA T,SUGIMOTO A,et al.Comparison of diagnostic reliability of out-of-center sleep tests for obstructive sleep apnea between adults and children[J].Int J Pediatr Otorhinolaryngol,2017,94:54-58.
[11] SALETU M T,KOTZIAN S T,SCHWARZINGER A,et al.Home sleep apnea testing is a feasible and accurate method to diagnose obstructive sleep apnea in stroke patients during in-hospital rehabilitation[J].J Clin Sleep Med,2018,14(9):1495-1501.
[12] PATEL N,RAISSI A,ELIAS S,et al.A modified definition for obstructive sleep apnea in home sleep apnea testing after stroke or transient ischemic attack[J].J Stroke Cerebrovasc Dis,2018,27(6):1524-1532.
[13] CABEZAS E,PéREZ-WARNISHER M T,TRONCOSO M F,et al.Sleep disordered breathing is highly prevalent in patients with lung cancer:results of the sleep apnea in lung cancer study[J].Respiration,2019,97(2):119-124.
[14] GAMALDO C E,GAMALDO A A,HOU L T,et al.When a private community neurology practice executes home sleep apnea testing:benefits identified and lessons learned in a retrospective observational study[J].Sleep Health,2018,4(2):217-223.
[15] ABUMUAMAR A M,DORIAN P,NEWMAN D,et al.A comparison of two nights of ambulatory ssleep testing in arrhythmia patients[J].Sleep Disord,2018,2018:2394146.
[16] ROMEM A,ROMEM A,KOLDOBSKIY D,et al.Diagnosis of obstructive sleep apnea using pulse oximeter derived photoplethysmographic signals[J].J Clin Sleep Med,2014,10(3):285-290.
[17] SETTY A R.Underestimation of sleep apnea with home sleep apnea testing compared to in-laboratory sleep testing[J].J Clin Sleep Med,2017,13(4):531-532.
[18] BIANCHI M T,GOPARAJU B.Potential underestimation of sleep apnea severity by at-home kits:rescoring in-laboratory polysomnography without sleep staging[J].J Clin Sleep Med,2017,13(4):551-555.
[19] CHEN H,LOWE A A,BAI Y,et al.Evaluation of a portable recording device (ApneaLink) for case selection of obstructive sleep apnea[J].Sleep Breath,2009,13(3):213-219.
[20] BALLESTER E,SOLANS M,VILA X,et al.Evaluation of a portable respiratory recording device for detecting apnoeas and hypopnoeas in subjects from a general population[J].Eur Respir J,2000,16(1):123-127.
[21] CLAMAN D,MURR A,TROTTER K.Clinical validation of the Bedbugg in detection of obstructive sleep apnea[J].Otolaryngol Head Neck Surg,2001,125(3):227-230.
[22] ABRAHAMYAN L,SAHAKYAN Y,CHUNG S,et al.Diagnostic accuracy of level IV portable sleep monitors versus polysomnography for obstructive sleep apnea:a systematic review and meta-analysis[J].Sleep Breath,2018,22(3):593-611.
[23] LIGHT M P,CASIMIRE T N,CHUA C,et al.Addition of frontal EEG to adult home sleep apnea testing:does a more accurate determination of sleep time make a difference?[J].Sleep Breath,2018,22(4):1179-1188.
[24] CHEN K,ZHANG C,MA J,et al.Sleep staging from single-channel EEG with multi-scale feature and contextual information[J].Sleep Breath,2019.
[25] SABIL A,VANBUIS J,BAFFET G,et al.Automatic identification of sleep and wakefulness using single-channel EEG and respiratory polygraphy signals for the diagnosis of obstructive sleep apnea[J].J Sleep Res,2019,28(2):e12795.
[26] THOMAS R J,MIETUS J E,PENG C K,et al.An electrocardiogram-based technique to assess cardiopulmonary coupling during sleep[J].Sleep,2005,28(9):1151-1161.
[27] 樊蕾.心肺耦合分析技术的临床应用与研究进展[J].世界睡眠医学杂志,2017,4(3):169-174.
[28] LEE S H,CHOI J H,PARK I H,et al.Measuring sleep quality after adenotonsillectomy in pediatric sleep apnea[J].Laryngoscope,2012,122(9):2115-2121.
[29] SCHRAMM P J,THOMAS R J.Assessment of therapeutic options for mild obstructive sleep apnea using cardiopulmonary coupling measures[J].J Clin Sleep Med,2012,8(3):315-320.
[30] 谢敏,雷飞,郭丹,等.心肺耦合分析技术对阻塞性睡眠呼吸暂停的诊断价值[J].中华医学杂志,2018,98(20):1565-1569.
[31] 冯晶,吴惠涓,王宗文,等.心肺耦合技术与多导睡眠图对睡眠呼吸事件判读的一致性分析[J].中华神经科杂志,2017,50(8):606-612.
[32] AURORA R N,SWARTZ R,PUNJABI N M.Misclassification of OSA severity with automated scoring of home sleep recordings[J].Chest,2015,147(3):719-727.
[33] LABARCA G,DREYSE J,SALAS C,et al.Differences between manual and automatic analysis in determining the severity of obstructive sleep apnea using home sleep apnea testing[J].Sleep Med,2018,47:66-71.
[34] MAGALANG U J,JOHNS J N,WOOD K A,et al.Home sleep apnea testing:comparison of manual and automated scoring across international sleep centers[J].Sleep Breath,2019,23(1):25-31.