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Noninvasive monitoring of respiratory mechanics during sleep

¹ Unitat Biofisica i Bioenginyeria, Facultat Medicina, Universitat Barcelona-Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), and ² Sleep Laboratory, Hospital Clinic Provincial-IDIBAPS, Barcelona, Spain

CORRESPONDENCE: R. Farré, Unitat de Biofisica i Bioenginyeria, Facultat de Medicina, Casanova 143, E-08036 Barcelona, Spain. Fax: 34 934024516. E-mail: rfarre@ub.edu

Keywords: Monitoring, sleep apnoea diagnosis and treatment, sleep-disordered breathing, upper airway obstruction, upper airway patency

Received: June 16, 2004
Accepted August 2, 2004

This work was supported in part by Ministerio de Ciencia y Tecnología (SAF2002-03616 and SAF2003-01334) and Ministerio de Sanidad y Consumo (RedRespira-ISCiii-RTIC-03/11), Spain.

Abstract

The sleep apnoea–hypopnoea syndrome is characterised by recurrent obstructions of the upper airway, resulting in sleep disruption and arterial oxygen desaturations. Noninvasive assessment of respiratory mechanics during sleep is helpful in facilitating the diagnosis and treatment of patients with sleep apnoea–hypopnoea syndrome. This series summarises the different tools that are currently available to noninvasively assess respiratory mechanics during sleep breathing disturbances. These techniques are classified according to the main variable monitored: ventilation, breathing effort or airway obstruction. Changes in patient ventilation are assessed by recording flow or volume signals by means of pneumotachographs, thermistors or thermocouples, nasal prongs or thoraco-abdominal bands. Common tools to noninvasively assess breathing efforts are the thoraco-abdominal bands and the pulse transit time technique. Upper airway obstruction is noninvasively characterised by its upstream resistance and its critical pressure or by means of the forced oscillation technique. Given the technical and practical limitations of each technique, combining different tools improves the reliability and robustness of patient assessment during sleep.