Apneic and obstructive non-apneic sleep respiratory events (ONEs)

¹ Pulmonary Service, San Pedro de Alcántara Hospital, Cáceres, Spain; and CIBER de enfermedades respiratoria (CibeRes), Spain
² Pulmonary Service, General Yagüe, Burgos. Spain; Primary Care Center San Jorge, Cáceres, Spain; Mathematics Dept, Extremadura University, Badajoz, Spain; Rearch unit, San Pedro de Alcántara Hospital, Cáceres, Spain; Hospital Clinic. IDIBAPS, Barcelona, Spain; and CIBER de enfermedades respiratoria (CibeRes), Spain
³ Pulmonary Service, San Pedro de Alcántara Hospital, Cáceres, Spain
⁴ Primary Care Center San Jorge, Cáceres, Spain; and CIBER de enfermedades respiratoria (CibeRes), Spain
⁵ Primary Care Center San Jorge, Cáceres, Spain; and Mathematics Dept, Extremadura University, Badajoz, Spain
⁶ Rearch unit, San Pedro de Alcántara Hospital, Cáceres, Spain
⁷ Hospital Clinic. IDIBAPS, Barcelona, Spain; and CIBER de enfermedades respiratoria (CibeRes), Spain

^* To whom correspondence should be addressed. E-mail: fmasa{at}separ.es.

	Abstract

Obstructive non-apneic event (ONEs) scoring is shrouded in confusion. This is important in mild patients, where precision is crucial.

1) to identify ONEs using esophageal pressure (EP) (EP-ONEs) and a non-invasive (NI) method (NI-ONEs); 2) to compare both methods of scoring and 3) to determine the contribution of ONE definitions to clinical findings.

Patients with suspected sleep apnoeas (RDI10) during a first PSG were subjected to a second with an EP measurement. EP-ONEs and NI-ONEs were defined as an increase in EP or discernible reduction in the amplitude of thoraco-abdominal bands with both desaturation and/or arousal. Bland and Altman's analysis established agreement. Comparisons were made between EP-ONEs, NI-ONEs and clinical findings.

In our sample (n: 90), the addition of an arousal to the NI-ONEs or EP-ONEs with only desaturation increased the number of NI-ONEs by 329% and 362%, respectively. NI-ONEs with arousal and/or desaturation detected 91% of EP-ONEs. The association with sleepiness depended on the incorporation of arousal into the definition of ONEs.

In mild patients, the addition of an arousal to ONEs with only desaturation markedly increased RDI, with probable therapeutic implications. Scoring respiratory events as apnoea and ONEs is easier and sufficiently accurate.