The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study

Pierre Mayer,1 Alberto Herrero Babiloni,1– 4 Gabrielle Beetz,2 Serguei Marshansky,1 Zeina Kaddaha,1 Pierre H Rompré,3 Vincent Jobin,1 Gilles J Lavigne1– 3 1Faculté de Médecine, Hôpital Hôtel-Dieu du Centre Hospitalier de l&...

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Autores principales:	Mayer P, Herrero Babiloni A, Beetz G, Marshansky S, Kaddaha Z, Rompré PH, Jobin V, Lavigne GJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	“sleep apnea” “autonomic arousals” “apnea hypopnea index” “respiratory disturbance index” “polysomnography” “portable monitor devices”. Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/11b3109702004a5f8a07761c6d499cef
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id	oai:doaj.org-article:11b3109702004a5f8a07761c6d499cef
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	“sleep apnea” “autonomic arousals” “apnea hypopnea index” “respiratory disturbance index” “polysomnography” “portable monitor devices”. Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	“sleep apnea” “autonomic arousals” “apnea hypopnea index” “respiratory disturbance index” “polysomnography” “portable monitor devices”. Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Mayer P Herrero Babiloni A Beetz G Marshansky S Kaddaha Z Rompré PH Jobin V Lavigne GJ The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study
description	Pierre Mayer,1 Alberto Herrero Babiloni,1– 4 Gabrielle Beetz,2 Serguei Marshansky,1 Zeina Kaddaha,1 Pierre H Rompré,3 Vincent Jobin,1 Gilles J Lavigne1– 3 1Faculté de Médecine, Hôpital Hôtel-Dieu du Centre Hospitalier de l’Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada; 2Research Center, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l’île-de-Montréal, Université de Montréal, Montréal, Québec, Canada; 3Department of Oral Health, Faculté de Médecine Dentaire, Université de Montréal, Montréal, Québec, Canada; 4Division of Experimental Medicine, McGill University, Montréal, Québec, CanadaCorrespondence: Alberto Herrero BabiloniResearch Center, Hôpital du Sacré-Coeur de Montreal, CIUSSS du Nord-de-l’Île-de-Montréal, Université De Montréal, 5400 Boul Gouin O, Montréal, QC H4J 1C5, CanadaTel +1 514-338-2222Fax +1 514-238-2531Email herre220@umn.eduBackground: Autonomic arousals can be considered as surrogates of electroencephalography (EEG) arousals when calculating respiratory disturbance index (RDI). The main objective of this proof of concept study was to evaluate the use of heart rate acceleration (HRa) arousals associated with sleep respiratory events in a population undergoing full polysomnography (type 1) and in another undergoing portable monitor study (type 3). Our hypothesis is that when compared to other commonly used indexes, RDI based on HRa will capture more events in both types of recording.Materials and Methods: A retrospective analysis was performed in two different populations of patients with suspected OSA: a) 72 patients undergoing one night of type 1 recording and b) 79 patients undergoing one night of type 3 recording. Variables for type 1 were 4% oxygen desaturation index (ODI), apnea/hypopnea index (AHI), RDI based on EEG arousals (RDIe), and RDI based on HRa with threshold of 5bpm (RDIa5). For type 3, variables were 4% ODI, AHI, and RDIa5 (it is not possible to calculate RDIe due to the absence of EEG). Calculated data were 1) Mean values for each sleep disturbance index in type 1 and 3 recordings; 2) Frequency of migration from lower to higher OSA severity categories using RDIa5 in comparison to AHI (thresholds: ≥ 5/h mild, ≥ 15/h moderate, ≥ 30/h severe); and 3) Bland–Altman plots to assess agreement between AHI vs RDIe and RDIa5 in type 1 population, and AHI vs RDIa5 in type 3 populations.Results: More respiratory disturbance events were captured with RDIa5 index in both type 1 and type 3 recordings when compared to the other indexes. In type 1 recording, when using RDIa5 37% of patients classified as not having OSA with AHI were now identified as having OSA, and a total of 59% migrated to higher severity categories. In type 3 recording, similar results were obtained, as 37% of patients classified as not having OSA with AHI were now identified as having OSA using RDIa5, and a total of 55% patients migrated to higher severity categories. Mean differences for RDIa5 and AHI in type 1 and 3 populations were similar.Conclusion: The use of autonomic arousals such as HRa can help to detect more respiratory disturbance events when compared to other indexes, being a variable that may help to capture borderline mild cases. This becomes especially relevant in type 3 recordings. Future research is needed to determine its validity, optimization, and its clinical significance.Keywords: sleep apnea, autonomic arousals, apnea-hypopnea index, respiratory disturbance index, polysomnography, portable monitor devices
format	article
author	Mayer P Herrero Babiloni A Beetz G Marshansky S Kaddaha Z Rompré PH Jobin V Lavigne GJ
author_facet	Mayer P Herrero Babiloni A Beetz G Marshansky S Kaddaha Z Rompré PH Jobin V Lavigne GJ
author_sort	Mayer P
title	The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study
title_short	The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study
title_full	The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study
title_fullStr	The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study
title_full_unstemmed	The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study
title_sort	evaluation of autonomic arousals in scoring sleep respiratory disturbances with polysomnography and portable monitor devices: a proof of concept study
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/11b3109702004a5f8a07761c6d499cef
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spelling	oai:doaj.org-article:11b3109702004a5f8a07761c6d499cef2021-12-02T08:21:05ZThe Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study1179-1608https://doaj.org/article/11b3109702004a5f8a07761c6d499cef2020-07-01T00:00:00Zhttps://www.dovepress.com/the-evaluation-of-autonomic-arousals-in-scoring-sleep-respiratory-dist-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Pierre Mayer,1 Alberto Herrero Babiloni,1– 4 Gabrielle Beetz,2 Serguei Marshansky,1 Zeina Kaddaha,1 Pierre H Rompré,3 Vincent Jobin,1 Gilles J Lavigne1– 3 1Faculté de Médecine, Hôpital Hôtel-Dieu du Centre Hospitalier de l’Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada; 2Research Center, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l’île-de-Montréal, Université de Montréal, Montréal, Québec, Canada; 3Department of Oral Health, Faculté de Médecine Dentaire, Université de Montréal, Montréal, Québec, Canada; 4Division of Experimental Medicine, McGill University, Montréal, Québec, CanadaCorrespondence: Alberto Herrero BabiloniResearch Center, Hôpital du Sacré-Coeur de Montreal, CIUSSS du Nord-de-l’Île-de-Montréal, Université De Montréal, 5400 Boul Gouin O, Montréal, QC H4J 1C5, CanadaTel +1 514-338-2222Fax +1 514-238-2531Email herre220@umn.eduBackground: Autonomic arousals can be considered as surrogates of electroencephalography (EEG) arousals when calculating respiratory disturbance index (RDI). The main objective of this proof of concept study was to evaluate the use of heart rate acceleration (HRa) arousals associated with sleep respiratory events in a population undergoing full polysomnography (type 1) and in another undergoing portable monitor study (type 3). Our hypothesis is that when compared to other commonly used indexes, RDI based on HRa will capture more events in both types of recording.Materials and Methods: A retrospective analysis was performed in two different populations of patients with suspected OSA: a) 72 patients undergoing one night of type 1 recording and b) 79 patients undergoing one night of type 3 recording. Variables for type 1 were 4% oxygen desaturation index (ODI), apnea/hypopnea index (AHI), RDI based on EEG arousals (RDIe), and RDI based on HRa with threshold of 5bpm (RDIa5). For type 3, variables were 4% ODI, AHI, and RDIa5 (it is not possible to calculate RDIe due to the absence of EEG). Calculated data were 1) Mean values for each sleep disturbance index in type 1 and 3 recordings; 2) Frequency of migration from lower to higher OSA severity categories using RDIa5 in comparison to AHI (thresholds: ≥ 5/h mild, ≥ 15/h moderate, ≥ 30/h severe); and 3) Bland–Altman plots to assess agreement between AHI vs RDIe and RDIa5 in type 1 population, and AHI vs RDIa5 in type 3 populations.Results: More respiratory disturbance events were captured with RDIa5 index in both type 1 and type 3 recordings when compared to the other indexes. In type 1 recording, when using RDIa5 37% of patients classified as not having OSA with AHI were now identified as having OSA, and a total of 59% migrated to higher severity categories. In type 3 recording, similar results were obtained, as 37% of patients classified as not having OSA with AHI were now identified as having OSA using RDIa5, and a total of 55% patients migrated to higher severity categories. Mean differences for RDIa5 and AHI in type 1 and 3 populations were similar.Conclusion: The use of autonomic arousals such as HRa can help to detect more respiratory disturbance events when compared to other indexes, being a variable that may help to capture borderline mild cases. This becomes especially relevant in type 3 recordings. Future research is needed to determine its validity, optimization, and its clinical significance.Keywords: sleep apnea, autonomic arousals, apnea-hypopnea index, respiratory disturbance index, polysomnography, portable monitor devicesMayer PHerrero Babiloni ABeetz GMarshansky SKaddaha ZRompré PHJobin VLavigne GJDove Medical Pressarticle“sleep apnea”“autonomic arousals”“apnea hypopnea index”“respiratory disturbance index”“polysomnography”“portable monitor devices”.PsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 12, Pp 443-451 (2020)

The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study

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