Programmpunkt

18:21–18:28

Titel: Ein "wearable patch-based" Polysomnographie System zur Durchführung von Schlafstudien: Der Effekt von 2012 AASM Hypopnoe Regeln auf den AHI bei gesunden Personen.
ID: KV17
Art: Kurzvortrag
Redezeit: 4 + 3 min
Session: Kurzvorträge 2
Therapie und Grundlagen der SBAS

Referent: Hartmut Schneider (Frankfurt/DE)


Abstract - Text

Fragestellung


Introduction


Current home sleep test (HST) devices are limited by an absence of EEG, or by being too cumbersome to use. We developed a wireless PSG system (Onera Health, NL) consisting of four disposable patches to record EEG, EOG, EMG, SaO2, ECG, bioimpedance derived respiratory airflow and effort, airflow via nasal cannula, snoring sounds, body position, actigraphy, and leg movements. Signals are stored on reusable electronic modules attached to each patch.


Aim 1 is to determine set-up time of Onera wearable PSG system


Aim 2 is to compare two hypopnea scoring rules, Rule 1 with >3% fall in SaO (AASM 2007)2 only to Rule 2  >3% fall in SaO2 or arousal (ASSM 2012)

Patienten und Methoden

Methods


We measured PSG hook-up time in 15 healthy laypersons (6 male, 9 female, age 18-to-70 yrs, BMI 29.7±5.2 kg/m2).


We also enrolled 6 additional asymptomatic healthy volunteers (2 male, 4 female, age 27-to-33 yrs, BMI 24.3±5.7 kg/m2) with history of occasional snoring, on which we scored the apnea-hypopnea index (AHI) using data from our patch-based PSG system recorded at home. We evaluated scoring using the 2016 AASM rules for hypopneas in comparison to the 2007 AASM rules requiring a greater than 3% fall in SaO2 for obstructive hypopneas.

Schlussfolgerungen

Conclusion


The wireless, patch-based PSG system is an easy and fast method for setting up a high fidelity full polysomnography in the home.


The presence of EEG, EOG and EMG signals allows to determine NREM and REM statistics, respiratory and non-respiratory arousal indices, AHI and hyponeas with and without hypoxia, e.g. those that are terminated by arousal only.


In normal individuals, using cortical arousal criteria for hypopneas, the AHI is more pronounced in NREM compared to REM sleep.


Implikacations


The Onera patch-based PSG system enables sleep diagnostic services to patients who could not have easy access to gold standard sleep studies, e.g. home bound patients, home care facilities and hospital beds.


The Onera PSG system may extend the diagnostic capacity of sleep physicians.


HST devices without EEG may underestimate the event rate of obstructive hypopneas and the degree of sleep abnormalities in young and particularly asymptomatic individuals. 

Ergebnisse

Results


Aim 1: Mean hook-up time for applying all four patches and electronic modules was 4:42 ± 1:20 min.


Aim 2: Mean home sleep efficiency was 89.5 SE 1.9% with an average REM% of 20 SE 6.7%. When comparing the 2016 vs 2007 AASM rules for scoring hypopneas, the AHI increased more than threefold during NREM (9.0 SE 2.0/h vs 2.7 SE 0.8/h; p<0.03) and minimally during REM (11.7 SE 2.3/h and 7.1/h SE 1.8/h; p<0.01), implying an overall increase in the AHI from 3.7 SE 0.8/h to 9.9 SE 1.9/h; p<0.02. One subject changed AHI category from normal to mild (3.6 to 14.4/h), another from mild to moderate (12.7 to 26.3/h) using the 2016 AASM rules.