微动敏感床垫式睡眠监测系统诊断阻塞性睡眠呼吸暂停及睡眠参数一致性评价

Evaluation of consistency between Micro-Motion-Sensitive Mattress Sleep Monitoring System and polysomnography in diagnosing obstructive sleep apnea and assessing sleep parameters

目的评价微动敏感床垫式睡眠监测系统(MSMSMS)在阻塞性睡眠呼吸暂停(OSA)诊断及睡眠评估中多参数与多导睡眠监测(PSG)相比的一致性。方法67例拟诊OSA的受试者同步使用PSG及MSMSMS记录多导睡眠参数,比较两者在OSA诊断及分度上的一致性,以及分别在呼吸事件、血氧事件、睡眠基本信息及睡眠结构参数上的一致性。计量资料采取了配对t检验,Bland-Altman分析以及组内相关系数(ICC),等级资料采取了weighted kappa分析。结果MSMSMS与PSG对照,诊断轻度以上、中度以上、重度OSA的曲线下面积分别为1、0.999和0.967(P<0.001);两种分层诊断结果的weighted kappa系数为0.841(95%CI:0.766~0.928,P<0.001)。其中呼吸暂停低通气指数(AHI)、呼吸暂停指数(AI)以及血氧指标组内相关系数分别为0.967(0.943,0.980)、0.937(0.900,0.961)、0.900(0.837,0.939)和0.936(0.891,0.962);两者在除低通气指数(HI)[0.181(-0.032,0.387),P=0.036]外的其他呼吸事件和血氧指标判读上具有很高的一致性(P<0.001);在睡眠结构的判读上,两者在浅睡眠比例和时间、深睡眠时间上具有中等程度的一致性。结论MSMSMS与PSG在OSA诊断和分度中具有高的敏感度和特异度。除了呼吸事件和血氧指标具有较强的一致性外,MSMSMS在评判OSA患者的睡眠结构上也有一定的意义。

Objective To evaluate the consistency of multiple parameters between the Micro-Motion-Sensitive Matress Sleep Monitoring System(MSMSMS)and polysomnography(PSG)in the diagnosis of obstructive sleep apnea(OSA)and sleep assessment.Methods Sixty-seven subjects suspected of having OSA underwent PSG and MSMSMS simultaneously to record multiple sleep parameters.The consistency between PSG and MSMSMS in the diagnosis and grad-ing of OSA,as well as the consistency in respiratory events,blood oxygen events,sleep basic information,and sleep structure parameters,was compared.Paired t-test,Bland-Altman analysis,and intraclass correlation coefficient(ICC)were used for continuous data,and weighted kappa analysis was used for categorical data.Results Compared with PSG,the areas under the curve for diagnosing mild,moderate,and severe OSA were 1,0.999,and 0.967,respectively(P<0.001);the weighted kappa coefficient for the two diagnostic results was 0.841(95%CI:0.766-0.928,P<0.001).The intraclass correlation coefficients of the apnea-hypopnea index(AHI),apnea index(AI),and blood oxygen indexes were 0.967(0.943,0.980),0.937(0.900,0.961),and 0.900(0.837,0.939),respectively,and 0.936(0.891,0.962).Except for the hypopnea index(HI)[0.181(-0.032,0.387),P=0.036],there was high consistency in the interpretation of other respiratory events and blood oxygen indexes(P<0.001).There was a moderate level of consis-tency between the two methods in the interpretation of sleep structure,including the proportion and time of light sleep and the time of deep sleep.Conclusionn MSMSMS has high sensitivity and specificity in the diagnosis and grading of OSA compared with PSG.In addition to strong consistency in respiratory events and blood oxygen indexes,MSMSMS also has certain significance in evaluating the sleep structure of OSA patients.