ABSTRACT
Este artículo presenta un método no obstructivo para la detección del síndrome de apnea-hipopnea del sueño (SAHS). El flujo respiratorio es medido indirectamente a través de un colchón sensorizado (PBS Pressure Bed Sensor) que incluye 8 transductores de presión. Mediante la transformada de Hilbert se obtiene la amplitud instantánea de las señales respiratorias y se reduce la información a través del análisis de componentes principales (ACP). Los eventos respiratorios (ERs apneas/hipopneas) se localizan como una reducción en la amplitud instantánea resultante y se contabilizan en el índice de eventos respiratorios (IER), un índice de severidad similar al oficial apnea-hypopnea index (AHI). El PBS se analiza agrupando primero la información de pares de canales y después utilizando los 8 canales. Los IER se evalúan comparándolos con el AHI en diferentes niveles de severidad. En el diagnóstico de pacientes sanos y patológicos se obtuvo una sensibilidad, especificidad y exactitud de 92%, 100% y 96% respectivamente, utilizando la información de dos u ocho canales. Con estos resultados podemos proponer el uso del PBS como una alternativa para el diagnóstico del SAHS en ambientes fuera del hospital, ya que no requiere la presencia de un clínico especialista para su uso.
This manuscript presents an unobtrusive method for sleep apneahypopnea syndrome (SAHS) detection. The airflow is indirectly measured through a sensitive mattress (Pressure Bed sensor, PBS) that incorporates multiple pressure sensors into a bed mattress. The instantaneous amplitude of each sensor signal is calculated through Hilbert transform, and then, the information is reduced via principal component analysis. The respiratory events (ERs -apneas/hypopneas) are detected as a reduction in the resulting instantaneous amplitude and accounted in the respiratory event index (IER), which is a severity indicator similar to the offcial apnea-hypopnea index (AHI). The respiratory signals extracted from PBS are analyzed first by clustering the information coming from channel pairs, and then using the eight channels. The IER performance is compared with the AHI for different severity categories. For the diagnosis of healthy and pathological patients we obtain a sensitivity, specificity and accuracy of 92%, 100% and 96%, respectively using two or eight PBS channels. These results suggest the possibility to propose PBS as an alternative tool for SAHS diagnosis in home environment.
ABSTRACT
Overlap syndrome can be defined as a coexistence of chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome (SAHS). The association of COPD and SAHS has been suspected because of the frequency of both diseases. Prevalence of COPD and SAHS is respectively 10 and 5% of the adult population over 40 years of age. However, a recent study has shown that the prevalence of SAHS is not higher in COPD than in the general population. The coexistence of the two diseases is only due to chance. SAHS does not affect the pathophysiology of COPD and vice versa. Prevalence of overlap syndrome is expected to occur in about 0.5% of the adult population over 40 years of age. Patients with overlap syndrome have a more profound hypoxemia, hypercapnia, and pulmonary hypertension when compared with patients with SAHS alone or usual COPD patients without SAHS. To treat the overlap syndrome, nocturnal noninvasive ventilation (NIV) or nasal continuous positive airway pressure (nCPAP) can be applied with or without nocturnal oxygen supplement.
Subject(s)
Adult , Humans , Hypoxia , Continuous Positive Airway Pressure , Hypercapnia , Hypertension, Pulmonary , Noninvasive Ventilation , Oxygen , Prevalence , Pulmonary Disease, Chronic ObstructiveABSTRACT
Objective To develop a portable sleep monitoring system with low burden. Methods Information from signals related with sleep were used and dug. Electrodes from patients' body were reduced to decrease patient's physiological and psychological burden. Results Polysomnography(PSG) is the gold standard in detecting the Sleep Apnea Hypopnea Syndrome disease at present. While this method has its problems, such as complicated operation, large expenditure and big physiology and psychology burden for the patient. A sleep monitor system was introduced which has the advantages of convenience, practicality, small physiology and psychology burden for the patient. Conclusion The result indicates that this device is warmly welcomed by doctors and patients, and it is a new device for the diagnosis of the SAHS disease.
ABSTRACT
Objective To observe the effect and safety of acupuncture treatment on refractory auditory hallucination in schizophrenia patients. Methods The 100 patients clinically diagnosed as refractory auditory hallucination of schizophrenia were randomized into test group and control group with 50 in each. The control group was treated with risperidone alone while the test group was treated with acupuncture on the basis of TCM syndrome differentiation in addition to risperidone. One month was one course,totally 3 courses of treatment was given. The clinical effect of both groups was observed. The effect in different courses of disease and the effect in different syndromes of the test group were compared respectively. Before and after treatment the brief psychiatric rating scale (BPRS),specific auditory hallucination scale(SAHS),and treatment emergent symptom scale (TESS) were adopted to score the patients of both groups. Results In the test group,there were 3 cases lost,the total effective rate was 72.34%; while in the control group,there was 1 case lost,the total effective rate was 38.78%,the difference being significant (P 0.05). The difference in BPRS and SHRS scores at the same period of time after 2nd and 3rd courses of treatment of the two groups was significant (P