Sleep Apnea Syndrome Clinical Trial
Official title:
Screening for Sleep Apnea Using Home Recording of the Double Loop Gain as a Measure of Periodic Breathing
The purpose of this study is to determine the double loop index (DLI) threshold with optimal sensitivity and specificity. The investigators hypothesize that the DLI gives a better reflection of the pathophysiology of the disease than the apnea-hypopnea-index (AHI).
Sleep apnea syndrome (SAS) is characterized by repetitive events of apnea and hypopnea.
These events are often part of a periodic breathing pattern, in which relative
hyperventilation is followed by apnea or hypopnea.
Recently the investigators described the 'double-loop gain' of the respiratory control
system as a measure of periodic breathing. This is a frequency-dependent variable which
describes 1) the tendency of the respiratory system to oscillate at a given frequency and 2)
the degree to which the relation between oscillations in ventilation and oscillations in
arterial blood gas values is linear. The underlying hypothesis is that periodic breathing
results from negative feedback regulation of arterial O2 and CO2 pressure through the
chemoreflexes. The double-loop gain describes the gain in the negative feedback loop under
the assumption that accidental changes occur in both ventilation and arterial blood gas
pressures. A simple version of the double-loop gain is derived from nasal pressure changes
and arterial O2 saturation. From all-night recordings, the 'double-loop index' (DLI) can be
derived, which is determined by the time during which the double-loop gain exceeds a given
threshold.
Currently, the presence of sleep-apnea is determined by the apnea-hypopnea index (AHI),
using in-hospital sleep recording. With a growing number of referrals, waiting lists for
sleep registration are emerging. Screening for SAS using home-measurement of nasal pressure
and SaO2 seems to be a good alternative. The investigators hypothesize that the DLI derived
from these signals gives a better reflection of the pathophysiology of the disease than the
AHI. As a result, the investigators expect that the DLI improves the distinction between
healthy and diseased subjects in comparison to the simple counting of apneas and hypopneas.
This is reflected in a higher area under the ROC curve, which describes the sensitivity and
specificity of the test.
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Observational Model: Cohort, Time Perspective: Cross-Sectional
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