A Device For Ambulatory Heart Rate, Oxygen Saturation And Snoring Recording

170

R Ri is sk k o of f t tr ra af ff fi ic c a ac cc ci id de en nt ts s i in n p pa at ti ie en nt ts s w wi it th h s sl le ee ep p--d di is so or rd de er re ed d b br re ea at th h--i in ng g: : r re ed du uc ct ti io on n w wi it th h n na as sa al l C CP PA AP P Fifty nine patients completed the study. The accident rate was significantly decreased from 0.8 per 100,000 km (untreated) to 0.15 per 100,000 km with nCPAP treatment. Variables that were considered to be likely to increase accident risk (sleeping spells, fatigue, vigilance test reaction time, daytime sleep latency) also improved with treatment.We conclude that treatment of sleep-disordered breathing by nasal continuous positive airway pressure is related to reduction in patient motor vehicle accident rates, probably due to the reversal of excessive daytime sleepiness. Eur Respir J., 1996Respir J., , 9, 2606 This study is part of the research project 2.9107: "Sleep related breathing disorders and traffic security", carried out on behalf of the "Bundesanstalt für Straβenwesen".

Section: Methodsmentioning

confidence: 99%

Risk of traffic accidents in patients with sleep-disordered breathing: reduction with nasal CPAP

Cassel¹,

Ploch²,

Becker³

et al. 1996

170

“…The MESAM IV is a portable device with four-channel digital recording, which has been described previously [18]. The system records heart rate, snoring, oxygen saturation and body position.…”

Section: Mesam IVmentioning

confidence: 99%

“…The same period was used both for manual and automatic analysis. Two manual scores (MS) were developed using criteria based on those proposed by PENZEL [18]. The manual scores were calculated by a two-step process.…”

Section: Mesam IVmentioning

confidence: 99%

Diagnostic accuracy of a portable recording device (MESAM IV) in suspected obstructive sleep apnoea

Esnaola

Durán²,

Infante‐Rivard³

et al. 1996

D Di ia ag gn no os st ti ic c a ac cc cu ur ra ac cy y o of f a a p po or rt ta ab bl le e r re ec co or rd di in ng g d de ev vi ic ce e ( (M ME ES SA AM M I IV V) ) i in n s su us sp pe ec ct te ed d o ob bs st tr ru uc ct ti iv ve e s sl le ee ep p a ap pn no oe ea a S. Esnaola*, J. Durán**, C. Infante-Rivard + , R. Rubio**, A. Fernández + Diagnostic accuracy of a portable recording device (MESAM IV) in suspected obstructive sleep apnoea. S. Esnaola, J. Durán, C. Infante-Rivard, R. Rubio, A. Fernández. ERS Journals Ltd 1996. ABSTRACT: This study evaluated the accuracy of a portable recording device (MESAM IV) in identifying obstructive sleep apnoea (OSA).The MESAM IV system measures arterial oxygen saturation (Sa,O 2 ), heart rate, snoring sounds and body position, and allows both automatic and manual scoring of the recordings. Nocturnal polysomnography and MESAM IV recordings were performed simultaneously in 150 patients with suspected OSA, and were analysed blindly by a different observer. Patients with an apnoea-hypopnoea index (AHI) greater than or equal to 10 were diagnosed as having OSA. In the evaluation of the discriminatory ability of MESAM IV scores, the cut-off point was set to minimize first the exclusion of truly diseased patients (i.e. false-negative interpretations), and then the confirmation of nondiseased subjects (i.e. false-positives).When used as an exclusion test, the portable device reached a sensitivity of 0.98 and a specificity of 0.78; as a confirmation test, these values were 0.69 and 0.97, respectively. These results were achieved with manual scoring, which was superior to automatic scoring. Manual scoring was also better than automatic scoring when OSA was defined according to other threshold values (≥5, 15 and 20) for the AHI.The combination of MESAM IV manual scores could reduce the need for diagnostic polysomnography in three quarters of the patients clinically suspected of having obstructive sleep apnoea, substantially reducing costs associated with diagnostic procedures.

“…Both devices were recently described [13,14]. Briefly, the MESAM 4 (dimensions 190×135×45 mm and total weight 900 g including current supplying batteries) allowed four parameters to be monitored: breathing sounds, heart rate, arterial oxygen saturation (SaO 2 ) and body position.…”

Section: Mesammentioning

confidence: 99%

Hand-scoring of MESAM 4 recordings is more accurate than automatic analysis in screening for obstructive sleep apnoea

Koziej¹,

Cieślicki²,

Gorzelak³

et al. 1994

The MESAM 4 system, developed to monitor breathing sounds, heart rate, arterial oxygen saturation (SaO 2 ) and body position, was proposed as a screening method for obstructive sleep apnoea (OSA). The aim of the study was to assess the accuracy of hand-scoring versus automatic-scoring in screening for obstructive sleep apnoea.The study population consisted of 56 patients, 51 males, and 5 females, mean age 47±10 yrs, suspected of having obstructive sleep apnoea. Full polysomnography and MESAM 4 recordings were performed simultaneously. The apnoea+hypop-noea index was hand-scored in polysomnography and in MESAM 4. The handscoring in MESAM 4 was based on analysis of breathing sounds, heart rate and SaO 2 changes taken together. The automatic-scoring system of MESAM 4 calculated oxygen desaturation index, heart rate variation index and intermittent snoring index.The diagnosis of obstructive sleep apnoea (apnoea+hypopnoea index ≥10) was established by polysomnography in 37 patients. Sensitivity and specificity of handscored MESAM 4 diagnosis were 100 and 63%, respectively. Sensitivity and specificity of MESAM 4 diagnosis with automatic-scoring were: from oxygen desaturation index 100 and 27%; from heart rate variation index 81 and 74%; and from intermittent snoring index 92 and 16%, respectively.We suggest that hand-scoring of MESAM 4 is more accurate than automaticscoring in screening for obstructive sleep apnoea. Eur Respir J., 1994Respir J., , 7, 1771 Monitoring of physiological phenomena during sleep is more helpful in the recognition of OSA, than looking for signs which can be observed during wakefulness and are only indirectly connected with sleep-disordered breathing, i.e. nonspecific changes of the flow-volume loop or articulation of certain vowels.Simultaneous recording of several variables should, in principle, give better results than single parameter analysis. Such a device should be characterized by its noninvasiveness (interpreted as resulting in no interruption of sleep), accuracy and high stability of recording lasting for several hours, and also its simplicity in application and scoring [10].It seems that the MESAM 4 (Madaus Inc., Germany) fulfils these criteria. Its use was previously reported by STOOHS and GUILLEMINAULT [11]. However, in their study only automatic analysis of recorded variables was considered. The aim of this validation study was to assess the accuracy of hand-scoring versus automatic-scoring of MESAM 4 in screening for OSA. Material and methods PatientsWe studied patients who were referred to the sleep laboratory suspected of having sleep/wake disorders. They underwent general clinical examination and filled a typical sleep questionnaire, based on the Marburg questionnaire [12], in the presence of their bed-partners. The next step in the study consisted of eligible subjects complaining either of loud and irregular snoring or excessive daytime somnolence, or whose bed-partner observed apnoeic pauses during sleep.Fifty six patients were admitted to the study, 51 males and...