MESAM: A Heart Rate and Snoring Recorder for Detection of Obstructive Sleep Apnea

Penzel, Thomas; Amend, Gregory; Meinzer, K.; Peter, J. H.; Wichert, P. von

doi:10.1093/sleep/13.2.175

Cited by 105 publications

(60 citation statements)

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“…The snoring microphone is air-coupled to the skin with a small air leak to attenuate very low frequency noise from body movements, similar to the approach used in the Madaus Electronics Sleep Apnoea Monitor (MESAM) system (Madaus Electronics, Freiburg, Germany) [14]. The 1.5 cm disc bearing the microphone was stuck to the neck, using double-sided adhesive rings, level with the thyroid cartilage prominence but 2 cm laterally.…”

Section: Techniquesmentioning

confidence: 99%

Mandibular advancement devices for the control of snoring

Stradling

Negus²,

Smith³

et al. 1998

Eur Respir J

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Patients presenting with the complaint of antisocial snoring have very few options available to them of proven efficiency. Mandibular advancement devices worn intra-orally at night, have recently been shown in controlled trials to help mild to moderate obstructive sleep apnoea. However, there are no properly controlled studies with objective measurements on the use of such appliances for the management of antisocial snoring. Fifteen patients, already established on mandibular advancement devices for the control of snoring, were asked to participate in this study. They were studied over two nights, using a portable sleep monitoring device at home, both with and without their mandibular advancement devices in place (in randomized order). Snoring was measured using a surface throat microphone. In addition oxygen saturation and indirect beat to beat blood pressure were measured. The latter (using pulse transit time) provided an index of autonomic "arousals" and a measure of inspiratory effort. In nearly all of these highly selected patients the mandibular advancement devices reduced significantly the amount of snoring from a median of 193 to 20 snores x h(-1) (p<0.0001). In addition there was a reduction in respiratory effort, implying enlargement of the upper airway whilst wearing the appliance. These patients only represent those who were able to tolerate the appliance. With such clear evidence of their potential efficacy, and no suggestion from other studies of any harm, it would seem reasonable to introduce this approach into the management of antisocial snoring.

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Section: Techniquesmentioning

confidence: 99%

Mandibular advancement devices for the control of snoring

Stradling

Negus²,

Smith³

et al. 1998

Eur Respir J

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“…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%

“…Sounds defined as "snoring" or "loud snoring" were recognized by a system of filters and amplifiers based on power spectral analysis [4,14]. If the relative power of frequencies between 100 and 800 Hz exceeded 50%, it was defined as "snoring".…”

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

Eur Respir J

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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...

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“…These patterns are reported by several authors [3,4] as cyclic variations with particularly high amplitude modulation corresponding to phases of apnea and bradycardia followed by an increase in heart rate and the corresponding stop of apnea. Fig 1. demonstrates such a characteristic heart rate pattern for about 7 minutes from an OSA patient.…”

Section: Introductionsupporting

confidence: 61%

Heart rate variability analysis for patients with obstructive sleep apnea

Dickhaus

Maier

Bauch

2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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-Obstructive sleep apnea (OSA) is a common health concern associated with serious implications and increased cardiovascular morbidity and mortality. This study approaches the problem of identification OSA patients and detection of OSA phases on the basis of heart rate variability (HRV) analysis. Only a single ECG-channel is required for this purpose. We used data from the apnea ECG database [6]: 40 patients with documented OSA and 20 controls divided into a learning and a test set of equal size. Commonly used HRV measures as well as some novel parameters are tested. The results are compared by ROC-analysis and promising parameters are combined into a multidimensional vector and evaluated by means of a second order polynomial classifier. Best results are obtained from parameters calculated by time delay embedding and correlation analysis of the interbeat interval series. For the identification task, 95% sensitivity and 100% specitifity are achieved on the independend test set. The detection task yields an average classification rate of almost 85 %. Keywords -Heart rate variability, obstructive sleep apnea, time delay embedding, correlation analysis. I. INTRODUCTIONObstructive sleep apnea (OSA) is frequently associated with a variety of health implications: from moderate problems with breathing and snoring during night, daytime drowsiness up to severe restrictions in the cardiovascular system we find a wide range of different degrees of this illness. Mostly middle aged males are affected with an estimated prevalence of about 4% [1]. The clinical method of polysomnography is currently used for diagnosing OSA [2]. This procedure is timeconsuming and expensive and requires the patient's stay overnight in hospital in a specially equipped sleep laboratory for recording of different biosignals, e.g. respiratory and cardiovascular signals, the electroencephalogram, vital parameters etc.Meanwhile, there is some evidence that the cardiac rhythm respectively the time course of heart rate shows some specific patterns which occur frequently with OSA. These patterns are reported by several authors [3,4] as cyclic variations with particularly high amplitude modulation corresponding to phases of apnea and bradycardia followed by an increase in heart rate and the corresponding stop of apnea. Fig 1. demonstrates such a characteristic heart rate pattern for about 7 minutes from an OSA patient. Because of these findings Guilleminault [3] suggested to evaluate a simple screening method for the existence of OSA taking these cyclic patterns into consideration.The aim of our study follows this idea and is performed in two different steps: i.) (Identification) what means, to investigate, if patients with OSA could be identified from healthy subjects by means of heart rate variability parameters, and ii) (Detection) if for those patients phases of apnea during sleep could be detected by heart rate variability analysis of Holter ECGs. For both questions the information of only one electrocardiogram (ECG) channel is available. We ...

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MESAM: A Heart Rate and Snoring Recorder for Detection of Obstructive Sleep Apnea

Cited by 105 publications

References 0 publications

Mandibular advancement devices for the control of snoring

Mandibular advancement devices for the control of snoring

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

Heart rate variability analysis for patients with obstructive sleep apnea

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