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Slaap-registratie. Maurits de Ruiter (MD, DDS) NVTS pre-conference course 4 april 2019. Polysomnografie. 1. EEG - Electro- encephalography 2. ECG - Electro- cardiography 3. EOG - Electro- oculography 4. EMG - Electro- myography 5. Nasal and oral airflow 6. Pulse-oximetry
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Slaap-registratie Maurits de Ruiter (MD, DDS) NVTS pre-conference course 4 april 2019
Polysomnografie • 1. EEG - Electro-encephalography • 2. ECG - Electro-cardiography • 3. EOG - Electro-oculography • 4. EMG - Electro-myography • 5. Nasalandoralairflow • 6. Pulse-oximetry • 7. Body position • minimum of 12 channelsrequiring 22 wireattachments
Peripheral Arterial Tonometry (PAT) 14 studies 909 patiensavailablefor pooling Overall, correlation of the RDI and AHI was high (r = 0.889 [95% CI, 0.862-0.911]; P < .001). Studies comparingthe RDI between PAT and PSG had a combinedcorrelation of 0.879 (95% CI, 0.849-0.904; P < .001); thosecomparingthe AHI, 0.893 (0.857-0.920; P < .001); andthosecomparingthe ODI, 0.942 (0.894-0.969; P < .001). Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apneabyperipheral arterial tonometry: meta-analysis." JAMA Otolaryngology–Head & Neck Surgery 139.12 (2013): 1343-1350.
The WatchPat (ItamarMedical, Ltd) Pulseoximetry Actigraphy Peripheral Arterial Tonometry (PAT) Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apneabyperipheral arterial tonometry: meta-analysis." JAMA Otolaryngology–Head & Neck Surgery 139.12 (2013): 1343-1350.
Discussie • Niet in: • Patiënten met verdenking centraal slaapapneu • Periodiclimbmovement disorder • Moderate or severe pulmonarydisease • Neuromusculardisease • Congestiveheart failure Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apneabyperipheral arterial tonometry: meta-analysis." JAMA Otolaryngology–Head & Neck Surgery 139.12 (2013): 1343-1350.
Discussie • Wat kan PAT NIET? • differentieren tussen de verschillende type van slaapapneu (central, obstructive, mixed) • Advies van meeste studies is excluderen van patiënten met • Diabetes • Perifere neuropathy • Vasculopathy • Cardiovasculaire aandoeningen • Gebruik van α-adrenergic receptor–blockingagents. Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apneabyperipheral arterial tonometry: meta-analysis." JAMA Otolaryngology–Head & Neck Surgery 139.12 (2013): 1343-1350.
DiagnOSAS - OSAsense • Digitale vragenlijst • Berlin Questionnaire • STOP-BANG • Athens insomnia scale • Pulseoximeter
Samenvattend • PSG gouden standaard • PG type 3 en PAT mogelijk voor diagnostiek, maar onder specifieke voorwaarden • Onderscheid maken voor toepassing: • Screening • Diagnose • Follow-up • Nieuwe ontwikkelingen heel interessant!!
Hartelijk dank voor uw aandacht Maurits de Ruiter m.h.deruiter@amc.uva.nl