Sleep fragmentation: comparison of two definitions of short arousals during sleep in OSAS patients

Sleep fragmentation: comparison of two definitions of short arousals during sleep in OSAS patients

The measurement of arousals during sleep is useful to quantify sleep fragmentation. The criteria for electroencephalography (EEG) arousals defined by the American Sleep Disorders Association (ASDA) have recently been criticized because of lack of interobserver agreement. The authors have adopted a s...

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Bibliographic Details
Published in:The European respiratory journal Vol. 17; no. 4; pp. 723 - 727
Main Authors: Smurra, M.V, Dury, M, Aubert, G, Rodenstein, D.O, Liistro, G
Format: Journal Article
Language:English
Published: Leeds Eur Respiratory Soc 01-04-2001
Maney
Subjects:
Adult
Aged
Alpha Rhythm
Arousal - physiology
Biological and medical sciences
Chin - physiology
Electromyography
Female
Humans
Male
Medical sciences
Middle Aged
Pneumology
Polysomnography
Respiratory system : syndromes and miscellaneous diseases
Sleep Apnea, Obstructive - physiopathology
Sleep Deprivation - physiopathology
Sleep Stages
Human
Sleep apnea syndrome
Diagnosis
Polysomnography
Respiratory disease
Arousal
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Summary:The measurement of arousals during sleep is useful to quantify sleep fragmentation. The criteria for electroencephalography (EEG) arousals defined by the American Sleep Disorders Association (ASDA) have recently been criticized because of lack of interobserver agreement. The authors have adopted a scoring method that associates the increase in chin electromyography (EMG) with the occurrence of an alpha-rhythm in all sleep stages (Université Catholique de Louvain (UCL) definition of arousals). The aim of the present study was to compare the two scoring definitions in terms of agreement and repeatability and the time taken for scoring in patients with obstructive sleep apnoea syndrome (OSAS) of varying severity. Two readers using both ASDA and UCL definitions scored twenty polysomnographies (PSGs) each on two occasions. The PSGs were chosen retrospectively to represent a wide range of arousal index (from 6-82) in OSAS patients. There was no difference in the arousal indices between readers and between scoring methods. The mean+/-SD difference between the two definitions (the bias) was 1.1+/-3.76 (95% confidence interval: -0.66-2.86). There was a strong linear relationship between the arousal index scored with the two definitions (r=0.981, p<0.001). Mean+/-SD scoring duration was significantly shorter for UCL than for ASDA definitions (18.5+/-5.4 versus 25.3+/-6.6 min, p<0.001). In conclusion, it has been found that in obstructive sleep apnoea syndrome patients, the American Sleep Disorders Association and Université Catholique de Louvain definitions were comparable in terms of agreement and repeatability.
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ISSN:0903-1936
1399-3003
DOI:10.1183/09031936.01.17407230