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Title: [Utility of the type 3 portable monitor for the diagnosis of sleep disordered breathing in patients with stable heart failure].
Author: Yu B, Zhang XL, Li SN, Xu LY, Chang Y, Bi TR, Zhou B, Zuo YH, Zhao L, Pei YY, Zhu JH, Han F, Dong XS.
Journal: Zhonghua Yi Xue Za Zhi; 2021 Jun 15; 101(22):1676-1682. PubMed ID: 34126716.
Abstract:
Objective: To evaluate the utility of a type 3 portable monitor (PM) at home for the diagnosis of sleep disordered breathing (SDB) in patients with stable congestive heart failure (CHF). Methods: Seventy-six consecutive patients with CHF (61 males, 15 females, mean±standard deviation age (57.0±16.9) years) were enrolled from the sleep center of Peking university People's Hospital during January 2016 to January 2019, and underwent overnight, unattended home sleep apnea testing (HSAT) with a portable monitor followed by an overnight simultaneous polysomnogram (PSG) with in-laboratory portable monitor (in-lab PM) recording within one week. The consistency of apnea hypopnea index (AHI), obstructive sleep apnea index (OAI), central sleep apnea index (CAI) between HSAT and PSG as well as the in-lab PM and PSG were analyzed by Bland-Altman plot; the sensitivity and specificity of PM for the diagnosis of SDB in patients with CHF were evaluated. Results: The number of patients included in the final analysis were 65 in HSAT, 63 in in-lab PM and 65 in PSG. AHI [M(Q₁,Q₃)] was 26.1 (10.9,40.1) events/h by HSAT, 27.9 (11.3,43.2) events/h by in-lab PM, both were not different from AHI 29.0 (10.2,45.0) events/h by PSG (P>0.05). The AHI, OAI and CAI assessed by HSAT correlated significantly with those by PSG (r=0.892, 0.903, 0.831, P<0.05). Bland-Altman analysis of AHI, OAI, CAI by PSG versus HSAT showed a mean difference of 3.1 events/h, 0.8 events/h, 1.2 events/h; limits of consistency were -15.2 to 21.4 events/h, -9.7 to 11.3 events/h, -10.9 to 13.2 events/h, respectively. Based on a threshold of AHI ≥5 events/h, HSAT had 94.6% sensitivity, 75% specificity, compared to PSG. For detecting Cheyne-Stokes respiration (CSR), a sensitivity of 96.4%,a specificity of 97.2% were achieved, compared to PSG. Conclusion: Type 3 PM can be used to diagnose SDB in patients with CHF. 目的： 评估使用Ⅲ型便携式睡眠监测仪（PM）进行家庭睡眠呼吸暂停监测（HSAT）对稳定期充血性心力衰竭（CHF）患者睡眠呼吸障碍（SDB）的诊断价值。 方法： 纳入2016年1月至2019年1月就诊于北京大学人民医院睡眠中心的76例CHF患者，年龄（57.0±16.9）岁，其中男61例，女15例。先用Ⅲ型PM进行整夜无人值守的HSAT，1周内在睡眠中心同步进行多导睡眠监测（PSG）和实验室便携式睡眠监测（in-lab PM）。评估三种方法所得的呼吸暂停低通气指数（AHI）、阻塞型睡眠呼吸暂停指数（OAI）、中枢型睡眠呼吸暂停指数（CAI）的一致性，计算Ⅲ型PM诊断SDB敏感度和特异度。 结果： 完成HSAT、in-lab PM、PSG的患者分别为65、63和65例。HSAT、in-lab PM的AHI［M（Q₁，Q₃）］分别为26.1 （10.9，40.1）、27.9 （11.3，43.2）次/h，与PSG的AHI［29.0 （10.2，45.0）］差异均无统计学意义（均P>0.05）。HSAT与PSG的AHI、OAI、CAI均呈正相关（r值分别为0.892、0.903、0.831，均P<0.05），平均差值分别为3.1、0.8、1.2次/h，一致性区间分别为-15.2~21.4、-9.7~11.3、-10.9~13.2次/h。与PSG相比，AHI≥5次/h时，HSAT诊断SDB敏感度为94.6%，特异度为75.0%。以PSG作为金标准，HSAT诊断陈-施呼吸（CSR）的敏感度为96.4%，特异度为97.2%。 结论： Ⅲ型PM对CHF患者的SDB具有较高的诊断价值。.

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