Authors: Arvind Singh Hiba AlReefy Richard Hewitt Bhik Kotecha
Publish Date: 2008/05/08
Volume: 265, Issue: 12, Pages: 1489-1494
Abstract
ApneaGraph relies on measuring pressure and airflow simultaneously at different levels in the pharynx identifying the segment of airway obstruction and providing baseline respiratory parameters This study aims to evaluate ApneaGraph and correlate results with both sleep nasendoscopy and polysomnography This was a prospective study of 49 patients with snoring and/or obstructive sleep apnoea Thirty of the these patients underwent a PSG and an ApneaGraph study simultaneously in the Sleep Lab Nineteen patients attended the day surgery unit and had a sleep nasendoscopy with a 10min ApneaGraph analysis Polysomnography was used to validate the ApneaGraph system There are no significant differences independent t test P 015 between ApneaGraph compared to Polysomnography based on the apnoea–hypopnoea index total number of apnoeic events average oxygen saturations and maximum desaturation This suggests that the ApneaGraph can be used to assess OSA Statistically there is poor correlation between the two groups Spearman’s ρ 029 In the cases of discordance ApneaGraph places greater emphasis on a lower pharyngeal contribution This unique study analyses the ApneaGraph system in the diagnosis of obstructive sleep apnoea and snoring It demonstrates the benefits of this new system and highlights certain limitations in localizing the site and level of pharyngeal obstruction in patients with sleep disordersSleeprelated breathing disorders SRBD affect 1–4 of the population 1 causing daytime somnolence impaired work performance increased road traffic incidents hypertension and ischaemic heart disease 2 3 It is classically diagnosed by the inlaboratory overnight polysomnography PSG sleep study 4 However the limited number of sleep centres and beds often results in longwaiting lists for diagnosis and treatment of SRBD There is evidence that untreated sleep apnoea is both deleterious to the patient and expensive to the healthcare budget 5 6The AG200 ApneaGraph system MRA Medical UK is a relatively newer technology designed for the evaluation of SRBD It stores and analysis the cardiorespiratory pattern of a patient with simultaneous recording of two different sites in the upper airway using a micropressure and temperature transducer catheter By measuring pressure and airflow via temperature simultaneously in the pharynx it is possible to identify the segment of obstruction during sleep in patients with upper airway obstructions apnoea hypopnoea and snoring Previous work has shown that the use of continuous airway pressure and flow monitoring is repeatable 7 and reproducible between ambulatory and hospital settings 8Potentially the ApneaGraph system could replace home sleep studies and sleep nasendoscopy SNE as it can provide an equivalent level of information implying a significant costsaving It is also more portable with less connections compared to some other devices However the quality of information gathered from ApneaGraph AG and proberelated problems have not been evaluatedPatients awaiting an overnight sleep study based in the sleep lab or a sleep nasendoscopy on the elective waiting list were enrolled in to the study Two groups were defined the first was a comparison of the studied device ApneaGraph with full PSG Sleep acquisition computer Oxford Instruments UK in a dedicated sleep lab over a 6h period and the second included a synchronous recording of ApneaGraph with sleep nasendoscopy over a 10min period
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