Diagnosis of obstructive sleep apnea using a portable transducer catheter.
As an initial step in simplifying the diagnosis of sleep apnea with a view toward using portable equipment in the home setting, we examined the efficacy of a portable transducer catheter that measures intrathoracic pressure. This catheter, connected to a miniature data-logger, can be introduced nasally into the airway, and the data so collected can be acquired, stored, and analyzed off-line. We tested this catheter against standard nocturnal polysomnography in 10 patients suffering from obstructive sleep apnea. We found that by using a combination of the raw pressure signal and an envelope pressure signal, we accurately identified apneas and hypopneas, and classified them as obstructive, central, and mixed. For the 10 subjects studied, the polysomnographic apnea/hypopnea index was 34 + 30, versus 32 + 28 obtained by analysis of the pressure tracings. Analysis of 200 respiratory events identified one-by-one from polysomnograms and pressure tracings revealed close correspondence between the two methods. The average duration of apneas was 22.1 + 6.7 s as measured by polysomnography, versus 21.9 + 6.6 s as measured from pressure tracings. Furthermore, there was excellent agreement between the two methods (kappa = 0.89, 95% confidence limits = 0.84 to 0.94). We conclude that our technique for identifying apnea based on measurements of intrathoracic pressure using a thin, portable transducer catheter is a promising method for simplifying the diagnosis of this disorder.
Tvinnereim
M
M
Department of Otolaryngology, St. Michael's Hospital, University of Toronto, Canada.
Mateika
S
S
Cole
P
P
Haight
J
J
Hoffstein
V
V
D000328:Adult; D000368:Aged; D002404:Catheterization / Q000295:instrumentation*; D004867:Equipment Design; D004947:Esophagus; D005260:Female; D006801:Humans; D016247:Information Storage and Retrieval; D007440:Intubation / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D009305:Nasopharynx; D009666:Nose; D017286:Polysomnography; D011312:Pressure; D012123:Pulmonary Ventilation; D012815:Signal Processing, Computer-Assisted; D012891:Sleep Apnea Syndromes / Q000175:diagnosis*; D013909:Thorax; D014059:Tongue; D014160:Transducers, Pressure; D014827:Vocal Cords