Quantifying the magnitude of pharyngeal obstruction during sleep using airflow shape

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art_MANN_Quantifying_the_magnitude_of_pharyngeal_obstruction_during_sleep_2019.PDF (664.59 KB)
Citações na Scopus
31
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
EUROPEAN RESPIRATORY SOC JOURNALS LTD
Autores
MANN, Dwayne L.
TERRILL, Philip I.
AZARBARZIN, Ali
MARIANI, Sara
FRANCIOSINI, Angelo
CAMASSA, Alessandra
GEORGESON, Thomas
TARANTO-MONTEMURRO, Luigi
MESSINEO, Ludovico
Citação
EUROPEAN RESPIRATORY JOURNAL, v.54, n.1, article ID 1802262, 12p, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Rationale and objectives: Non-invasive quantification of the severity of pharyngeal airflow obstruction would enable recognition of obstructive versus central manifestation of sleep apnoea, and identification of symptomatic individuals with severe airflow obstruction despite a low apnoea-hypopnoea index (AHI). Here we provide a novel method that uses simple airflow-versus-time (""shape"") features from individual breaths on an overnight sleep study to automatically and non-invasively quantify the severity of airflow obstruction without oesophageal catheterisation. Methods: 41 individuals with suspected/diagnosed obstructive sleep apnoea (AHI range 0-91 events.h(-1)) underwent overnight polysomnography with gold-standard measures of airflow (oronasal pneumotach: ""flow"") and ventilatory drive (calibrated intraoesophageal diaphragm electromyogram: ""drive""). Obstruction severity was defined as a continuous variable (flow: drive ratio). Multivariable regression used airflow shape features (inspiratory/expiratory timing, flatness, scooping, fluttering) to estimate flow: drive ratio in 136264 breaths (performance based on leave-one-patient-out cross-validation). Analysis was repeated using simultaneous nasal pressure recordings in a subset (n=17). Results: Gold-standard obstruction severity (flow: drive ratio) varied widely across individuals independently of AHI. A multivariable model (25 features) estimated obstruction severity breath-by-breath (R-2=0.58 versus gold-standard, p<0.00001; mean absolute error 22%) and the median obstruction severity across individual patients (R-2=0.69, p<0.00001; error 10%). Similar performance was achieved using nasal pressure. Conclusions: The severity of pharyngeal obstruction can be quantified non-invasively using readily available airflow shape information. Our work overcomes a major hurdle necessary for the recognition and phenotyping of patients with obstructive sleep disordered breathing.
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URI
https://observatorio.fm.usp.br/handle/OPI/34187
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Coleções
Artigos e Materiais de Revistas Científicas - HC/InCor