零负荷微动敏感床垫式睡眠监测设备在阻塞性睡眠呼吸暂停筛查中的应用  

Validation of contactless micro-movement sensitive mattress sleep monitoring device for the detection of obstructive sleep apnea

作　　者：李焕 陈琪 陈雨行 房芳[1] LI Huan;CHEN Qi;CHEN Yuhang;FANG Fang(Department of Sleep Medical Center,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所睡眠医学中心,100029 [2]中国科学技术大学生物医学工程学院(苏州)-生命科学与医学部,中国科学院苏州生物医学工程技术研究所

出　　处：《心肺血管病杂志》2023年第5期427-430,436,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点研发计划项目(2020YFC2003600)。

摘　　要：目的:评估基于心冲击描记术的零负荷微动敏感床垫式睡眠监测设备(以下简称“床垫”)对阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)的诊断价值,以及该设备在筛查合并心血管疾病的OSA患者的能力。方法:连续纳入于北京安贞医院睡眠医学中心同时行整夜便携式睡眠监测(portable monitoring,PM)和床垫监测的患者。根据呼吸暂停-低通气指数(apnea hypopnea index,AHI)判断OSA的严重程度,床垫式睡眠监测设备根据计算机内置算法自动判读呼吸紊乱指数(respiratory disturbance index,RDI),将两种监测方式所得的AHI和RDI进行统计学分析,比较其相关性及诊断价值,监测结果在所有受试者以及在合并或不合并心血管疾病组进行对比。结果:最终对145例疑似OSA的受试者进行了ROC分析。在不同AHI阈值下(5、15、30),依据PM-AHI为标准检验床垫对于OSA的诊断价值。在PM-AHI分别为5、15、30时,ROC曲线面积在整个队列中分别表现为0.92,0.92,以及0.94(P<0.001)。在伴有心血管疾病组的患者,ROC曲线面积分别为0.92,0.93,0.95(P<0.001),不伴有心血管疾病组的患者,ROC曲线面积分别为0.91,0.84,0.86(P<0.001)。结论:零负荷微动敏感床垫式睡眠监测设备在评估临床上疑似OSA患者的能力是可接受的,可作为快速筛查OSA患者的工具。Objective:The goal of this study was to assessed the accuracy and utility of a new sleep monitoring device that based on ballistocardiograpgy for detecting sleep-disordered breathing by comparison with portable monitoring(PM),Especially,identify the difference of this ability between patients with or without cardiovascular disease.Methods:The study was a single-center,cross-sectional study.Patients who suspected with obstructive sleep apnea(OSA)and conducted a sleep assessment at sleep medical center were recruited.Participants underwent overnight PM and recorded data simultaneously with contactless sleep monitor,and the results of two methods were compared in all subjects,as well as in those with or without cardiovascular diseases.According to OSA severity degree based on apnea hypopnea index(AHI),Micro-movement mattress sleep monitoring system automatically interpreted respiratory disorder index according to the algorithm of the computer.The results of two methods were compared in all subjects and in those with or without cardiovascular abnormalities.Results:Finally,a total of 145 subjects were analyzed.Based on PM-AHI to identify the severity of OSA.The area of contactless sleep monitor under the ROC curve was 0.92,0.92,and 0.94 for the entire cohort(P<0.001).For patients with cardiovascular disease,the areas under the ROC curve was 0.92,0.93,and 0.95(P<0.001),for patients without cardiovascular disease,the curve areas under ROC were 0.91,0.84,and 0.86(P<0.001),respectively.Conclusions:Overall,the performance of contactless mattress sleep monitoring device to screening OSA patients was acceptable,and it can be used as a tool for rapid screening OSA.

关 键 词：阻塞性睡眠呼吸暂停 零负荷微动敏感床垫式睡眠监测设备 心冲击图 验证 

分 类 号：R54[医药卫生—心血管疾病]