Nocturnal Polysomnography With and Without Continuous Pharyngeal and Esophageal Pressure Measurements

Abstract

PSG with simultaneous pharyngeal and esophageal pressure measurements of the upper airway may interfere with sleep architecture and cause a bias. The aim of this study was to evaluate the degree of disturbance to sleep caused by inclusion of pressure measurements of the airway, and whether this would reduce the validity of the PSG. Thirty-two consecutive patients referred for PSG for possible obstructive sleep apnea syndrome (OSAS) were included. For pressure recordings, a 6-F silicone tube, 1.9 mm in diameter, containing six pressure transducers, was introduced through one nostril into the pharynx and esophagus. Each patient had two nocturnal PSGs, one of which included airway pressure measurements. There were no statistically significant differences between PSGs performed with and without simultaneous pressure recordings for the following sleep quality parameters: total sleep time, number of sleep-stage shifts, sleep efficiency, arousal during sleep (= intrasleep wakefulness), percent REM sleep, and number of microarousals. We did not find any statistically significant differences for respiratory parameters such as type, duration, and index of different respiratory events and snoring. However, there was a slight tendency for reduced sleep quality and oxygen saturation when pressure measurements were included. The only significant change seen was in the duration of non-REM sleep with oxygen saturation below 90%. The multisensor airway pressure probe demonstrated that proximal obstructions were more common than distal obstructions, and obstruction in one or two segments was far more frequent than obstruction in more than two.

Night-to-Night Variability in Sleep Disordered Breathing and the Utility of Esophageal Pressure Monitoring in Suspected Obstructive Sleep Apnea

“…Skatvedt et al tested 28 subjects and did not find any significant differences for respiratory parameters between PSGs completed with Pes and those without Pes, but only thermistors were used to measure respiratory flow. 13 Our data add to this limited literature, as we did not find a statistically Variability in SDB and Utility of Pes in Suspected OSA significant difference in the AHI change between the studies with and without Pes. This suggests that the use of the catheter does not change the upper airway characteristics sufficiently to predispose to increased upper airway resistance.…”

“…There are limited studies evaluating the utility of the addition of esophageal pressure monitoring to diagnose SDB, and many did not use nasal pressure monitoring. [10][11][12][13] A second night of polysomnographic recording may demonstrate OSA when the first did not due to a first-night effect and night-to-night variability. The first-night effect includes shorter total sleep time (TST), decreased sleep efficiency (SE), increased sleep onset latency, greater wakefulness after sleep onset, increased number of awakenings, and decreased rapid eye movement (REM) sleep.…”

Evaluation of ApneaGraph in the diagnosis of sleep-related breathing disorders

“…The AG device, in the diagnosis of OSA, compares favourably with polysomnography. Importantly, the addition of AG to patients having PSG does not signiWcantly aVect respiratory parameters [11].…”

Atuação fonoaudiológica na síndrome da apnéia e hipopnéia obstrutiva do sono: relato de caso

“…A polissonografi a é considerada um exame fundamental para controle da SAHOS, determinando a efi cácia das intervenções realizadas 10 . Em estudos realizados em pacientes com SAHOS percebeu-se que os mesmos apresentam saturação de oxigênio abaixo de 90% 20 . Os dados da primeira polissonografi a demonstram que a saturação média de oxigênio foi de 93%, chegando a uma mínima de 83%, já na segunda polissonografi a a saturação média foi de 99%, chegando à mínima de 92%.…”