Chest, Vol 98, 1341-1345, Copyright © 1990 by American College of Chest Physicians

ARTICLES

A limited diagnostic investigation for obstructive sleep apnea syndrome. Oximetry and static charge sensitive bed

E Svanborg, H Larsson, B Carlsson-Nordlander and R Pirskanen
Department of Clinical Neurophysiology, Karolinska Institutet, Soder Hospital, Stockholm, Sweden.

A simplified sleep apnea investigation consisting of combined oximetry and respiration movement monitoring was compared with conventional polysomnography. These two types of recordings were performed simultaneously during one night in 77 patients with suspected obstructive sleep apnea syndrome (OSAS). A static charge sensitive bed (SCSB) was used in the simplified recording because it provides a comfortable and reliable means of recording respiration movements. Periods of obstructive apneas gave a diamond-shaped periodic respiration movement pattern in the SCSB, usually accompanied by repetitive oxygen desaturations. The average number of desaturations greater than or equal to 4 percent per sleeping hour was termed the oxygen desaturation index (ODI) and compared with the apnea index (AI). In the whole population they were well correlated (p less than 0.0001, R2 = 0.41), but in individual cases there were considerable discrepancies. Patients with periodic respiration movements less than 18 percent of total sleeping time and ODI less than 2 never had AI greater than or equal to 5, whereas patients with periodic respiration greater than 45 percent and ODI greater than 6 always had AI greater than or equal to 5. Fifty-one of the 77 patients fulfilled these criteria. A bradycardia response to apneas was absent in 29 percent of patients with AI greater than or equal to 5. A combination of respiration movement and oximetry recording thus seems to give sufficient information to confirm or negate a diagnosis of OSAS in a majority of patients with clinical symptoms. In borderline patients, further investigations should be performed.

This article has been cited by other articles:

				Y. Peker, J. Carlson, and J. Hedner Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up Eur. Respir. J., September 1, 2006; 28(3): 596 - 602. [Abstract] [Full Text] [PDF]

				M. Marklund, H. Stenlund, and K. A. Franklin Mandibular Advancement Devices in 630 Men and Women With Obstructive Sleep Apnea and Snoring: Tolerability and Predictors of Treatment Success Chest, April 1, 2004; 125(4): 1270 - 1278. [Abstract] [Full Text] [PDF]

				D Schlosshan and M W Elliott Sleep * 3: Clinical presentation and diagnosis of the obstructive sleep apnoea hypopnoea syndrome Thorax, April 1, 2004; 59(4): 347 - 352. [Abstract] [Full Text] [PDF]

				W. W. Flemons, M. R. Littner, J. A. Rowley, P. Gay, W. M. Anderson, D. W. Hudgel, R. D. McEvoy, and D. I. Loube Home Diagnosis of Sleep Apnea: A Systematic Review of the Literature: An Evidence Review Cosponsored by the American Academy of Sleep Medicine, the American College of Chest Physicians, and the American Thoracic Society Chest, October 1, 2003; 124(4): 1543 - 1579. [Full Text] [PDF]

				E Levring Jaghagen, K. Franklin, and A Isberg Snoring, sleep apnoea and swallowing dysfunction: a videoradiographic study Dentomaxillofac. Radiol., September 1, 2003; 32(5): 311 - 316. [Abstract] [Full Text] [PDF]

				J.M. Calleja, S. Esnaola, R. Rubio, and J. Duran Comparison of a cardiorespiratory device versus polysomnography for diagnosis of sleep apnoea Eur. Respir. J., December 1, 2002; 20(6): 1505 - 1510. [Abstract] [Full Text] [PDF]

				F. P. Paulsen, P. Steven, M. Tsokos, K. Jungmann, A. Muller, T. Verse, and W. Pirsig Upper Airway Epithelial Structural Changes in Obstructive Sleep-disordered Breathing Am. J. Respir. Crit. Care Med., August 15, 2002; 166(4): 501 - 509. [Abstract] [Full Text] [PDF]

				Y. Peker, J. Hedner, J. Norum, H. Kraiczi, and J. Carlson Increased Incidence of Cardiovascular Disease in Middle-aged Men with Obstructive Sleep Apnea: A 7-Year Follow-up Am. J. Respir. Crit. Care Med., July 15, 2002; 166(2): 159 - 165. [Abstract] [Full Text] [PDF]

				T. MOOE, K. A. FRANKLIN, K. HOLMSTROM, T. RABBEN, and U. WIKLUND Sleep-disordered Breathing and Coronary Artery Disease . Long-term Prognosis Am. J. Respir. Crit. Care Med., November 15, 2001; 164(10): 1910 - 1913. [Abstract] [Full Text] [PDF]

				O. Sandberg, K.A. Franklin, G. Bucht, S. Eriksson, and Y. Gustafson Nasal continuous positive airway pressure in stroke patients with sleep apnoea: a randomized treatment study Eur. Respir. J., October 1, 2001; 18(4): 630 - 634. [Abstract] [Full Text] [PDF]

				L. GROTE, H. KRAICZI, and J. HEDNER Reduced alpha - and beta 2-Adrenergic Vascular Response in Patients with Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., October 1, 2000; 162(4): 1480 - 1487. [Abstract] [Full Text] [PDF]

				T. Mooe, K. A. Franklin, U. Wiklund, T. Rabben, and K. Holmstrom Sleep-Disordered Breathing and Myocardial Ischemia in Patients With Coronary Artery Disease Chest, June 1, 2000; 117(6): 1597 - 1602. [Abstract] [Full Text] [PDF]

				D. FRIBERG, T. ANSVED, K. BORG, B. CARLSSON-NORDLANDER, H. LARSSON, and E. SVANBORG Histological Indications of a Progressive Snorers Disease in an Upper Airway Muscle Am. J. Respir. Crit. Care Med., February 1, 1997; 157(2): 586 - 593. [Abstract] [Full Text]