Daniel J Schwartz1. 1. The Tampa Sleep Center, University Community Hospital, 3100 East Fletcher Avenue, Tampa, Florida 33613, USA. thetampasleepcenter@att.net
Abstract
BACKGROUND AND PURPOSE: Pulse transit time (PTT) is a non-invasive index which reflects changes in peripheral vascular resistance and intrathoracic pressure. PTT arousal index (PTT Ar/I) is defined as the frequency (number/hour) of a defined decrease in PTT which may serve as a marker for respiratory events, and associated arousals which occur in patients with obstructive sleep apnea (OSA). This study was designed to evaluate the PTT Ar/I before and after patients with OSA were treated with continuous positive airway pressure (CPAP). PATIENTS AND METHODS: Individuals referred for evaluation of possible OSA underwent split-night polysomnography (PSG). The findings from 144 consecutive patients with a respiratory disturbance index (RDI)>/=20, who demonstrated at least a 50% drop in RDI with CPAP, provide the basis for this analysis. The PTT Ar/I measured before and after CPAP were compared to other measures of severity for OSA, including RDI and arousal index. RESULTS: The PTT Ar/I correlates with the RDI (r=0.43, P</=0.0001) and with the arousal index (r=0.43, P<0.0001). Moreover, the decrease in RDI and arousal index that occurs with CPAP treatment correlates with a similar decrease in the PTT Ar/I (r=0.54, P<0.0001). CONCLUSIONS: The PTT Ar/I correlates well with other standard measures of severity in patients with OSA and is potentially a non-invasive marker with which to measure the frequency of disruptive events that occur during sleep.
BACKGROUND AND PURPOSE: Pulse transit time (PTT) is a non-invasive index which reflects changes in peripheral vascular resistance and intrathoracic pressure. PTT arousal index (PTT Ar/I) is defined as the frequency (number/hour) of a defined decrease in PTT which may serve as a marker for respiratory events, and associated arousals which occur in patients with obstructive sleep apnea (OSA). This study was designed to evaluate the PTT Ar/I before and after patients with OSA were treated with continuous positive airway pressure (CPAP). PATIENTS AND METHODS: Individuals referred for evaluation of possible OSA underwent split-night polysomnography (PSG). The findings from 144 consecutive patients with a respiratory disturbance index (RDI)>/=20, who demonstrated at least a 50% drop in RDI with CPAP, provide the basis for this analysis. The PTT Ar/I measured before and after CPAP were compared to other measures of severity for OSA, including RDI and arousal index. RESULTS: The PTT Ar/I correlates with the RDI (r=0.43, P</=0.0001) and with the arousal index (r=0.43, P<0.0001). Moreover, the decrease in RDI and arousal index that occurs with CPAP treatment correlates with a similar decrease in the PTT Ar/I (r=0.54, P<0.0001). CONCLUSIONS: The PTT Ar/I correlates well with other standard measures of severity in patients with OSA and is potentially a non-invasive marker with which to measure the frequency of disruptive events that occur during sleep.
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