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0496 CLASSIFICATION OF HYPOPNEA (OBSTRUCTIVE VERSUS CENTRAL) USING CHEST WALL EMG

Sleep (New York, N.Y.), 2017-04, Vol.40 (suppl_1), p.A185-A185 [Peer Reviewed Journal]

Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society]. All rights reserved. For permissions, please email: journals.permissions@oup.com 2017 ;Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society]. All rights reserved. For permissions, please email: journals.permissions@oup.com ;ISSN: 0161-8105 ;EISSN: 1550-9109 ;DOI: 10.1093/sleepj/zsx050.495

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  • Title:
    0496 CLASSIFICATION OF HYPOPNEA (OBSTRUCTIVE VERSUS CENTRAL) USING CHEST WALL EMG
  • Author: Berry, RB ; Ryals, S ; Wagner, MH
  • Subjects: Classification
  • Is Part Of: Sleep (New York, N.Y.), 2017-04, Vol.40 (suppl_1), p.A185-A185
  • Description: Abstract Introduction: Current AASM classification of hypopnea as obstructive (H-OB) is based on identification of flattening of inspiratory airflow, chest-abdominal paradox, or snoring. If none are present a hypopnea is classified as central (H-CEN). We hypothesized that surface chest wall EMG (CW-EMG, right 8th intercostal space), as a reflection of inspiratory effort, would be useful for hypopnea classification and AASM criteria validation. Methods: 25 Consecutive adult positive airway pressure (PAP) titration studies with at least 10 hypopneas (including 3 putative central hypopneas) and an adequate CW-EMG signal were analyzed. The EMG signal was processed to remove ECG artifact, rectified and integrated. The integrated EMG signal (EF) was used to reflect effort. Five randomly chosen hypopneas from each patient were analyzed. An observer blind to CW-EMG and EF signals classified the hypopneas as OB or CEN based on AASM criteria. Inspiratory deflections in PAP flow (F) and EF were scaled based on pre-event breathing and a resistance (RES = EF/F) was calculated (pre-event breath RES = 1). An average RES for breaths in the first and second half of the hypopneas was calculated (odd number of breaths, middle breath included in both halves). The same observer classified hypopneas based ONLY on the smoothed flow (eliminating flattening), EF signal, and RES values. The two classifications (AASM and EF) were compared. Results: Events by AASM criteria: 68 H-OB and 32 H-CEN. The RES 1st half event (mean ± SD) was OB: 3.6 ± 3.4 versus CEN: 1.24 ± 0.7, P < 0.001 and 2nd half event was OB: 9.2 ± 8.0 versus CEN: 1.35 ± 0.7, P < 0.001. The RES ratio (RES 2nd /RES 1st half hypopnea) was OB: 3.3 ± 3.3 versus CEN 1.15 ± 0.3, P< 0.001. Agreement AASM/EF classifications: Kappa= 0.76, % agreement 89%. Conclusion: OB hypopneas had a greater resistance in both halves of the event than CEN hypopneas and the second half a larger relative RES (2nd half/1st half). There was good agreement between classification based on EF and AASM criteria. CW-EMG may be useful to classify hypopneas as obstructive or central. Support (If Any): None
  • Publisher: US: Oxford University Press
  • Language: English
  • Identifier: ISSN: 0161-8105
    EISSN: 1550-9109
    DOI: 10.1093/sleepj/zsx050.495
  • Source: ProQuest One Psychology
    Alma/SFX Local Collection
    ProQuest Central
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