title: Screening method for severe sleep-disordered breathing in hypertensive patients without daytime sleepiness.
abstract: The high prevalence of sleep-disordered breathing (SDB) in hypertensive patients has been well studied. However, regular screening of SDB in these patients is not performed routinely as the diagnostic procedures are both time-consuming and labour-intensive. Overnight portable device screening is useful, but is sometimes not acceptable for asymptomatic SDB patients. We evaluated the usefulness of daytime 30-min recording with a portable recording device during pulse wave velocity (PWV) measurement sessions as a screening method for detection of asymptomatic SDB in hypertensive patients. Eighty-one hypertensive patients underwent 30-min daytime screening session using a Type III portable recording device during PWV measurement. Each screening session was followed by full overnight Level I polysomnography (PSG). The screening session included recordings of airflow (mouth-nose), chest movement, oximetry, and electrocardiography. The correlation coefficient between respiratory disturbance index (RDI) by screening session and apnea-hypopnea index (AHI) by PSG was 0.64. Using AHI ≥ 30 as diagnostic of severe SDB, 47 of 80 patients had the disorder based on PSG results. Using an RDI cut-off value of 22, the sensitivity and specificity for detection of severe SDB were 86.1% and 64.5%, respectively. Daytime 30-min recording with a portable device for apnea detection during PWV recording is useful for screening of asymptomatic severe SDB in hypertensive patients.
authors.affiliation: The Department of Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan. tfrkw@med.teikyo-u.ac.jp
authors.forename: Taiji
authors.initials: T
authors.lastname: Furukawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Suzuki
authors.forename: Ikuko
authors.initials: I
authors.lastname: Funatogawa
authors.forename: Takaaki
authors.initials: T
authors.lastname: Isshiki
authors.forename: Yukihisa
authors.initials: Y
authors.lastname: Miyazawa
authors.forename: Tamio
authors.initials: T
authors.lastname: Teramoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Yano
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D010092:Oximetry; D017286:Polysomnography; D012123:Pulmonary Ventilation; D011674:Pulse; D012680:Sensitivity and Specificity; D012891:Sleep Apnea Syndromes / Q000175:diagnosis*; D035441:Thoracic Wall / Q000502:physiology