UNSPECIFIED (2003) Combined index of heart rate variability and oximetry in screening for the sleep apnoea/hypopnoea syndrome. JOURNAL OF SLEEP RESEARCH, 12 (1). pp. 53-61. ISSN 0962-1105

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Abstract

Many sleep centres employ a preliminary screening test in order to reduce the number of polysomnographies required in the routine diagnosis of the sleep apnoea/hypopnoea syndrome (SAHS). We investigated the combination of heart rate and oximetry information as a means of performing this test. A retrospective study of 100 patients with suspected SAHS was made. All patients had in-hospital polysomnography on one night. We estimated the number of respiratory event-related arousals by counting the number of autonomic arousals (assessed on the basis of changes in the heart interbeat interval) that were coincident with a rise in oximetry. The hourly index of such events was denoted the 'cardiac-oximetry disturbance index' (CODI). The median apnoea/hypopnoea index (AHI) was 16.5 (range 1.0-93.6) h(-1) . The CODI correlated significantly with the AHI (Spearman correlation coefficient r (s) = 0.88, P < 0.01), and the area (+/- standard error) under the receiver operating characteristic (ROC) was 0.94 +/- 0.05. Oximetry alone (based on 4% dips) was a less effective screening test (r (s) = 0.80, P < 0.01; area under ROC 0.83 +/- 0.06). Using 2% dips in oximetry offered comparable performance with the CODI (r (s) = 0.91, P < 0.01; area under ROC 0.93 +/- 0.04). The CODI was better correlated with the electroencephalograph arousal index (r (s) = 0.84, P < 0.01) than was oximetry (2% dips, r (s) = 0.57, P < 0.01). The CODI algorithm also offers an informal measure of self-validation: a large discrepancy between the number of autonomic arousals and the number of rises in oximetry indicates the presence of autonomic arousals without changes in oximetry (or vice versa). This self-validation mechanism identified several patients in this study, and may be useful in identifying sleep disruption due to chronic pain or other causes.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Journal or Publication Title:	JOURNAL OF SLEEP RESEARCH
Publisher:	BLACKWELL PUBLISHING LTD
ISSN:	0962-1105
Date:	March 2003
Volume:	12
Number:	1
Number of Pages:	9
Page Range:	pp. 53-61
Publication Status:	Published
URI:	http://wrap.warwick.ac.uk/id/eprint/10007

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