Younghoon Kwon1, Martin Baruch2, Patrick L Stafford3, Heather Bonner3, Yeilim Cho1, Sula Mazimba3, Jeongok G Logan4, Daichi Shimbo5, Sung-Ha Park6, Gen-Min Lin7, Ali Azarbarzin8, David A Calhoun9, Richard Berry10, Robert M Carey3. 1. Department of Medicine, University of Washington, Seattle, Washington. 2. Caretaker Medical Inc. 3. Department of Medicine. 4. School of Nursing, University of Virginia, Charlottesville, Virginia. 5. Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA. 6. Division of Cardiology, Yonsei University, Seoul, Korea. 7. Hualien Armed Forces General Hospital, Hualien, and Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 8. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. 9. Sentara Martha Jefferson Hospital, Charlottesville, Virginia. 10. Division of Pulmonary, Critical Care and Sleep, Department of Medicine, University of Florida, Gainesville, Florida, USA.
Abstract
BACKGROUND: Obstructive sleep apnoea (OSA) episode related blood pressure (BP) surge may mediate the association of OSA with cardiovascular disease. However, BP is not measured during a clinical sleep study. METHOD: We tested the feasibility of incorporating the Caretaker physiological monitor, which utilizes a novel continuous beat-to-beat (b-b) BP monitoring technology, into polysomnography (PSG) and aimed to characterize BP surges related to obstructive respiratory events. B-b BP was concurrently collected and merged with PSG data on a posthoc basis. We compared BP surge between mean respiratory (apnoea, hypopnea and desaturation-alone events) and nonrespiratory events (spontaneous or leg movement-related arousals). We examined the association of the degree of oxygen desaturation with BP surge in a given respiratory event combining all events. A total of 17 consecutive patients (12 men, mean 52 years old, nine diagnostic and eight split-night PSGs) undergoing clinically indicated PSG were included after excluding one patient with poor signal quality due to excessive movement. RESULTS: Caretaker was well tolerated. Mean respiratory BP surge ranged from 5 to 19 mmHg [Median (IQR) = 13.9 (9.5--16.2)]. Mean BP surge between the respiratory and nonrespiratory events was similar [13.8 (4.5) vs. 14.9 (5.3) mmHg, P = 0.13]. Accounting for the count distribution of desaturation/BP surge data pair events, there was a linear correlation between the degree of oxygen desaturation and BP surge (R = 0.57, P < 0.001). In eight patients undergoing split-night sleep studies, the number of BP surge events (≥10 mmHg/h) decreased during continuous positive airway pressure in all but one patient. CONCLUSION: We demonstrated highly variable OSA-related BP surge patterns using the Caretaker's b-b BP monitoring technology that has the potential to be integrated into sleep studies.
BACKGROUND: Obstructive sleep apnoea (OSA) episode related blood pressure (BP) surge may mediate the association of OSA with cardiovascular disease. However, BP is not measured during a clinical sleep study. METHOD: We tested the feasibility of incorporating the Caretaker physiological monitor, which utilizes a novel continuous beat-to-beat (b-b) BP monitoring technology, into polysomnography (PSG) and aimed to characterize BP surges related to obstructive respiratory events. B-b BP was concurrently collected and merged with PSG data on a posthoc basis. We compared BP surge between mean respiratory (apnoea, hypopnea and desaturation-alone events) and nonrespiratory events (spontaneous or leg movement-related arousals). We examined the association of the degree of oxygen desaturation with BP surge in a given respiratory event combining all events. A total of 17 consecutive patients (12 men, mean 52 years old, nine diagnostic and eight split-night PSGs) undergoing clinically indicated PSG were included after excluding one patient with poor signal quality due to excessive movement. RESULTS: Caretaker was well tolerated. Mean respiratory BP surge ranged from 5 to 19 mmHg [Median (IQR) = 13.9 (9.5--16.2)]. Mean BP surge between the respiratory and nonrespiratory events was similar [13.8 (4.5) vs. 14.9 (5.3) mmHg, P = 0.13]. Accounting for the count distribution of desaturation/BP surge data pair events, there was a linear correlation between the degree of oxygen desaturation and BP surge (R = 0.57, P < 0.001). In eight patients undergoing split-night sleep studies, the number of BP surge events (≥10 mmHg/h) decreased during continuous positive airway pressure in all but one patient. CONCLUSION: We demonstrated highly variable OSA-related BP surge patterns using the Caretaker's b-b BP monitoring technology that has the potential to be integrated into sleep studies.
Authors: Daniel J Gottlieb; Gayane Yenokyan; Anne B Newman; George T O'Connor; Naresh M Punjabi; Stuart F Quan; Susan Redline; Helaine E Resnick; Elisa K Tong; Marie Diener-West; Eyal Shahar Journal: Circulation Date: 2010-07-12 Impact factor: 29.690
Authors: Conrad Iber; Susan Redline; Adele M Kaplan Gilpin; Stuart F Quan; Lin Zhang; Daniel J Gottlieb; David Rapoport; Helaine E Resnick; Mark Sanders; Philip Smith Journal: Sleep Date: 2004-05-01 Impact factor: 5.849