Validation of Nasal Pressure for the Identification of Apneas/Hypopneas during Sleep
- 1 August 2002
- journal article
- research article
- Published by American Thoracic Society in American Journal of Respiratory and Critical Care Medicine
- Vol. 166 (3), 386-391
- https://doi.org/10.1164/rccm.2105085
Abstract
The reference standard for identifying apneas and hypopneas is a pneumotachograph, but using this can disrupt sleep. Nasal airflow estimation by measuring nasal pressure via nasal prongs is better tolerated by patients. However, nasal pressure has not been validated, using an event-by-event analysis, for detecting apneas/hypopneas during sleep. Eleven patients undergoing polysomnography wore a nasal mask capable of measuring nasal airflow (via pneumotachograph) and nasal pressure simultaneously. Each study was screened for respiratory disturbances, and from these 550 were randomly selected and blindly scored as an apnea/hypopnea or no event each using the pneumotachograph, nasal pressure, square root nasal pressure, and respiratory inductance sum signals independently. Agreement was measured using Cohen's kappa statistic. Intermeasurement agreements between the pneumotachograph and nasal pressure, square root nasal pressure, and respiratory inductance plethysmography sum were 0.76, 0.73, and 0.50, respectively. Inter- and intrarater agreements were, respectively, 0.68 and 0.60 for the pneumotachograph, 0.66 and 0.82 for nasal pressure, 0.61 and 0.78 for square root nasal pressure, and 0.47 and 0.76 for respiratory inductance plethysmography sum. These results indicate that nasal pressure has excellent agreement compared with a pneumotachograph and very good inter-/intrarater agreement. Square root transformation of the nasal pressure signal does not improve these levels of agreement, indicating that it is unnecessary in routine clinical practice for scoring apneas/hypopneas.Keywords
This publication has 19 references indexed in Scilit:
- Accuracy of Nasal Cannula Pressure Recordings for Assessment of Ventilation during SleepAmerican Journal of Respiratory and Critical Care Medicine, 2001
- Relevance of Linearizing Nasal Prongs for Assessing Hypopneas and Flow Limitation During SleepAmerican Journal of Respiratory and Critical Care Medicine, 2001
- Assessment of Inspiratory Flow Limitation Invasively and Noninvasively during SleepAmerican Journal of Respiratory and Critical Care Medicine, 1998
- Detection of Flow Limitation with a Nasal Cannula/ Pressure Transducer SystemAmerican Journal of Respiratory and Critical Care Medicine, 1998
- Evaluation of nasal prongs for estimating nasal flow.American Journal of Respiratory and Critical Care Medicine, 1997
- Comparison of polysomnography with ResCare Autoset in the diagnosis of the sleep apnoea/hypopnoea syndrome.Thorax, 1995
- Likelihood ratios for a sleep apnea clinical prediction rule.American Journal of Respiratory and Critical Care Medicine, 1994
- Flow limitation as a noninvasive assessment of residual upper-airway resistance during continuous positive airway pressure therapy of obstructive sleep apnea.American Journal of Respiratory and Critical Care Medicine, 1994
- Accuracy of Respiratory Inductive Plethysmography during Wakefulness and Sleep in Patients with Obstructive Sleep ApneaChest, 1992
- STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENTThe Lancet, 1986