Sleep & breathing = Schlaf & Atmung
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To assess the physiological meanings of the detrended fluctuation analysis (DFA) slope α and its relationship to spectral measures in heart rate variability, this study investigated changes of α and its corresponding spectral measures over various night-sleep stages. ⋯ The REM sleep attenuations appeared in ln(HF) and its derivatives, such as ln(LF/HF), ln(VLF/HF), and the overall DFA slope α values. The quantitative function of ln(VLF/HF) describes the α values constantly for overnight sleep stages, and it is not affected by age, LF, PLM, and AHI. Our findings therefore suggest that in sleep studies with spectral HRV measures, ln(VLF/HF) as a surrogate of the overall DFA slope α should be calculated at the same time.
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Meta Analysis
Effect of CPAP therapy on cardiovascular events and mortality in patients with obstructive sleep apnea: a meta-analysis.
Continuous positive airway pressure (CPAP) therapy may decrease the risk of mortality and cardiovascular events in patients with obstructive sleep apnea. However, these benefits are not completely clear. ⋯ CPAP therapy was associated with a trend of decreased risk of cardiovascular events. Furthermore, ESS and BP were significantly lower in the CPAP group. Larger randomized studies are needed to confirm these findings.
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Drug-induced sedation endoscopy (DISE) and simulated snoring (SimS) can locate the site of obstruction in patients with sleep-disordered breathing (SDB). There is clinical evidence for a change in collapsibility of the upper airway depending on the depth of sedation. So far, a dose-response relationship between sedation and collapsibility has not been demonstrated. ⋯ A dose-dependent change of patterns of obstructions can be observed during DISE under BIS monitoring indicating sedation depth. The obtained patterns of obstruction during DISE and SimS should thus be interpreted with regard to the sedation depth.
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STOP-Bang is a tool for predicting the likelihood for sleep-disordered breathing (SDB). In the conventional score, all variables are dichotomous. Our aim was to identify whether modifying the STOP-Bang scoring tool by weighting the variables could improve test characteristics. ⋯ Modifying the STOP-Bang score by weighting the variables and using continuous variables for BMI, age, and neck circumference can maintain sensitivity while improving specificity, positive likelihood ratio, and area under the receiver operating characteristic curve.
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Comparative Study
Comparison of a simple obstructive sleep apnea screening device with standard in-laboratory polysomnography.
Obstructive sleep apnea (OSA) is a common underdiagnosed sleep disorder. Various strategies have been employed to easily screen for OSA. The ApneaStrip® (AS - S.L.P. Ltd, Tel Aviv, Israel) is an FDA approved OSA screening device applied to the upper lip at home. We evaluated the performance of this device against simultaneous in-laboratory polysomnography (PSG) in a group of well-characterized OSA patients. ⋯ The AS has a high sensitivity for detection of OSA with AHI ≥ 15, but only modest specificity. The AS could be a useful component of an OSA screening program; however, negative results should be interpreted cautiously.