Watch—PAT睡眠监测系统与Compumedics多导睡眠监测系统的对比研究

Comparison of polysomnography and the Watch-PAT in the diagnosis of obstructive sleep apnea

目的评价一种通过测定外周交感活性来判断呼吸事件的便携式睡眠仪Watch—PAT诊断阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的效率和准确度。方法对20例疑诊OSAHS的患者在睡眠室由专业的技术人员同时进行多导睡眠仪（Compumedics）和Watch—PAT（型号：WP-200）监测。PSG的数据根据AASM指南由专业技术人员进行分析；Watch—PAT通过记录外周动脉弹性、心率、血氧饱和度和体位来判断呼吸暂停和低通气事件、血氧以及睡眠状态，并自动分析和生成报告。对比PsG和watch-PAT的数据，比较的指标包括呼吸暂停低通气指数（AHI）、平均血氧饱和度（SpO2mean）、最低血氧饱和度（SpO2min）、总睡眠时间（TST）和睡眠结构（REM／NREM）。结果受试者的年龄为（47．95±12．43）岁，体质量指数（BMI）为（28．82±4．15）kg／m^2。PSG监测的AHI是（37．65±31．34）次／h。Watch—PAT和PSG的AHI、SpO2min、SpO2mean、TST和REM／NREM均高度相关（r=0．99，0．97，0．98，0．78，0．69，P值均〈0．001）。Watch-PAT和PSG计算的AHI差异无统计学意义[（37．41±28．85）次jh比（37．65±31．34）次／hi，P〉0．05）。但Watch—PAT的TsT和REM／NREM要高于PSG的结果（P〈0．01）；Watch—PAT的SpO2 mean和SpO2 min也高于PSG的结果（P〈0．01）。当PSGAHI≥5次／h为诊断界值时，watch—PATAHI的ROC曲线下面积为1.0，其诊断的灵敏度和特异度分别是100％和100％（Watch—PATAHI≥6．95次／h）。当PSGAHI≥15次/h为诊断界值时，watch—PATAHI的ROC曲线下面积为0．98，其诊断的灵敏度和特异度分别是100％和85．7％（Watch—PATAHI≥18．4次／h）。通过Bland Altman图，可以看出PSG和Watch—PAT的诊断结果具有较好的符合度。结论Watch—PAT通过测定外周动脉弹性来判断呼吸事件和睡眠状态的方法简单易行，结果可靠。是一种简便有效的便携式睡眠监测仪。

Objective To assess the accuracy of a portable monitoring device based on peripheral arterial tonometry （PAT） to diagnose obstructive sleep apnea and hypopnea syndrom （OSAHS）. Methods Twenty adult subjects with suspected OSA simultaneously had a standard in laboratory polysomnogram （PSG） and wore the Watch-PAT200 during a full-night recording. PSG sleep and respiratory events were scored according to standard criteria. The Watch PAT200 records peripheral arterial tone, heart rate, oxygen saturation and actigraphy of which data were analyzed with an automated computerized algorithm. The accuracy of Watch-PAT200 in apnea hypopnea index （AHI）, SpO2, and sleep wake detection was assessed by comparison with data from simultaneous PSG recordings. Results Mean age was （47.95 ± 12.43） years, mean body mass index （28.82±4.15） kg/m^2 , mean PSG AHI （37.65±31.34） events per hour. There was a significant correlation between PAT AHI, SpO2min, SpO2mean, TST and REM/ NREM with the corresponding indexes obtained by PSG （ r =0.99,0.97,0.98,0.78,0.69, P 〈0. 001）, respectively. To assess sensitivity and specificity of Watch-PAT, we constructed receiver operator characteristic curves using a variety of AHI threshold values （5,15, events per hour）. The areas under the curve for the receiver-operator characteristic curves for Watch-PAT-AHI were 1.0 and 0.98 {or the PSG-AHI thresholds 5 and 10. Conclusions The Watch PAT is a device that can detect OSAHS with reasonable accuracy. Thus, the Watch-PAT may be a useful and simplified method for OSAHS diagnosis.