Variabilidad de la señal de frecuencia de pulso obtenida mediante pulsioximetría nocturna en pacientes con síndrome de apnea hipopnea del sueño

Campo, Félix del; Hornero, Roberto; Sanz, C. Zamarrón; González, Daniel Álvarez; Marcos, J. Víctor

doi:10.1016/j.arbres.2009.11.004

Cited by 5 publications

(2 citation statements)

References 27 publications

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“…Similarly, the entropy of respiratory sounds has been found to be higher in non-healthy subjects [ 36 ] and the entropy of mechanomyogram signals is also higher as the severity of COPD increases [ 52 ]. In the presence of OSAS, different studies reported higher non-linear measures values of overnight oximetry [ 33 , 34 ], airflow [ 35 ], and heart rate [ 21 , 26 , 53 ] derived from whole-night PSG. In these studies, it has been found that direct presence of apnoeic events modifies the normal cardiorespiratory dynamics towards higher disorderliness or disorganization, i.e., higher entropy.…”

Section: Discussionmentioning

confidence: 99%

Influence of Chronic Obstructive Pulmonary Disease and Moderate-To-Severe Sleep Apnoea in Overnight Cardiac Autonomic Modulation: Time, Frequency and Non-Linear Analyses

Álvarez

Sánchez-Fernández

Andrés-Blanco

et al. 2019

Entropy

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Chronic obstructive pulmonary disease (COPD) is one of the most prevalent lung diseases worldwide. COPD patients show major dysfunction in cardiac autonomic modulation due to sustained hypoxaemia, which has been significantly related to higher risk of cardiovascular disease. Obstructive sleep apnoea syndrome (OSAS) is a frequent comorbidity in COPD patients. It has been found that patients suffering from both COPD and OSAS simultaneously, the so-called overlap syndrome, have notably higher morbidity and mortality. Heart rate variability (HRV) has demonstrated to be useful to assess changes in autonomic functioning in different clinical conditions. However, there is still little scientific evidence on the magnitude of changes in cardiovascular dynamics elicited by the combined effect of both respiratory diseases, particularly during sleep, when apnoeic events occur. In this regard, we hypothesised that a non-linear analysis is able to provide further insight into long-term dynamics of overnight cardiovascular modulation. Accordingly, this study is aimed at assessing the usefulness of sample entropy (SampEn) to distinguish changes in overnight pulse rate variability (PRV) recordings among three patient groups while sleeping: COPD, moderate-to-severe OSAS, and overlap syndrome. In order to achieve this goal, a population composed of 297 patients were studied: 22 with COPD alone, 213 showing moderate-to-severe OSAS, and 62 with COPD and moderate-to-severe OSAS simultaneously (COPD+OSAS). Cardiovascular dynamics were analysed using pulse rate (PR) recordings from unattended pulse oximetry carried out at patients’ home. Conventional time- and frequency- domain analyses were performed to characterise sympathetic and parasympathetic activation of the nervous system, while SampEn was applied to quantify long-term changes in irregularity. Our analyses revealed that overnight PRV recordings from COPD+OSAS patients were significantly more irregular (higher SampEn) than those from patients with COPD alone (0.267 [0.210–0.407] vs. 0.212 [0.151–0.267]; p < 0.05) due to recurrent apnoeic events during the night. Similarly, COPD + OSAS patients also showed significantly higher irregularity in PRV during the night than subjects with OSAS alone (0.267 [0.210–0.407] vs. 0.241 [0.189–0.325]; p = 0.05), which suggests that the cumulative effect of both diseases increases disorganization of pulse rate while sleeping. On the other hand, no statistical significant differences were found between COPD and COPD + OSAS patients when traditional frequency bands (LF and HF) were analysed. We conclude that SampEn is able to properly quantify changes in overnight cardiovascular dynamics of patients with overlap syndrome, which could be useful to assess cardiovascular impairment in COPD patients due to the presence of concomitant OSAS.

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Section: Discussionmentioning

confidence: 99%

Influence of Chronic Obstructive Pulmonary Disease and Moderate-To-Severe Sleep Apnoea in Overnight Cardiac Autonomic Modulation: Time, Frequency and Non-Linear Analyses

Álvarez

Sánchez-Fernández

Andrés-Blanco

et al. 2019

Entropy

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“…Así, se ha empleado junto con la frecuencia cardiaca extraída de la propia pulsioximetría [279,280,281,282], o en otras ocasiones con señales derivadas de la PSG nocturna, como es el caso del ECG [283]. Los estudios realizados con pulsioximetría muestran una sensibilidad que varía entre el 45% y el 98% y una especificidad entre el 47% y el 100% [284].…”

Section: Estudio Del Estado Del Arte De La Señal De Oximetríaunclassified

Utilidad de las señales de oximetría y flujo aéreo en el diagnóstico simplificado de la apnea obstructiva del sueño. Diseño de un test automático domiciliario

Cerezo Hernández

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Obstructive Sleep Apnea (OSA) is a respiratory disorder characterized by recurrent episodes of total (apnea) or partial (hypopnea) absence of airflow during sleep. Recent epidemiological studies estimate the prevalence of OSA at 10% in men and 3% in middleaged women. Untreated OSA produces a significant decrease in quality of life and is associated with the main causes of mortality in industrialized countries, such as arterial hypertension, coronary heart disease, cerebrovascular accidents, diabetes and cancer. However, OSA is considered an underdiagnosed chronic disease. Continuous positive airway pressure (CPAP) is the most common therapeutic option, being non-invasive, efficient and cost-effective, so favoring the diagnostic process is essential.Nocturnal polysomnography (PSG) in a specialized sleep unit is the reference diagnostic method. The apnea-hypopnea index (AHI) derived from PSG makes it possible to rule out or confirm the pathology and determine its severity. However, PSG has low availability and accessibility, being costly and time consuming for the healthcare system and intrusive for the patients. These major limitations contributed to overload the available resources leading to long waiting lists, which reduces its effectiveness as the only diagnostic technique for OSA. There is a significant problem of accessibility of patients to sleep laboratories, which leads to a significant delayed access to the diagnosis and treatment resources of the disease. Consequently, in recent years there has been a significant demand xxii aéreo (FA) y enfoque de doble canal SpO2+FA.

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Technological Transfer of Knowledge in Pulmonology

Fiz

Morera

2012

Archivos de Bronconeumología (English Edition)

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Variabilidad de la señal de frecuencia de pulso obtenida mediante pulsioximetría nocturna en pacientes con síndrome de apnea hipopnea del sueño

Cited by 5 publications

References 27 publications

Influence of Chronic Obstructive Pulmonary Disease and Moderate-To-Severe Sleep Apnoea in Overnight Cardiac Autonomic Modulation: Time, Frequency and Non-Linear Analyses

Influence of Chronic Obstructive Pulmonary Disease and Moderate-To-Severe Sleep Apnoea in Overnight Cardiac Autonomic Modulation: Time, Frequency and Non-Linear Analyses

Utilidad de las señales de oximetría y flujo aéreo en el diagnóstico simplificado de la apnea obstructiva del sueño. Diseño de un test automático domiciliario

Technological Transfer of Knowledge in Pulmonology

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