The Clinical study of Sleep-Disordered Breathing and Dynamic Physiological Index

• Main Authors: Wen-Yao Pan, 潘文堯
• Other Authors: Hsien-Tsai Wu
• Format: Others
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/2ppmrv

博士 === 國立東華大學 === 電機工程學系 === 105 === Although sleep-disordered breathing (SDB) is one of the major causes of cardiovascular disease, it is usually neglected in the general population. The clinical characteristics of SDB include frequent snoring, cessation of respiratory effort during sleep, daytime sleepiness, and loss of concentration at work. Most of the affected individuals sought medical assistance until their symptoms were remarkable. As we know, polysomnography (PSG) is the golden standard for the definite diagnosis of SDB. In our research for SDB, we have developed the “Snoring Burst Index (SBI)”, a simple method for evaluating the association between vibration signals of snoring and the severity of obstructive sleep apnea (OSA) from a clinic-based population. We obtained the vibration signals of snoring from an overnight PSG database and found a good correlation between SBI and OSA severity which was defined by the apnea-hypopnea index (AHI). In addition, we created a sleep apnea alarm model in which the nocturnal snoring signals were acquired from the sensor attached to the neck and analyzed by the SBI to evaluate OSA severity. Finally, we used multi-scale entropy (MSE) to assess the complexity of R-R intervals of electrocardiographic signals after sleep. The study results showed that lower MSE was observed in patients with OSA as compared with that in those unaffected. Furthermore we compared the electrocardiographic signals between those with OSA and those without at 1 hour and 3 hours sleep. The results showed that deep sleep was associated with greater large scale sample entropy than the light sleep in unaffected individuals. Increase in large scale sample entropy in late phase of sleep was noted in normal snoring and CPAP groups. While moderate OSA group exhibited small scale entropy drop in the late phase, both small and small scale sample entropy decreased in late phase in severe OSA group. However, no differences were noted in mild OSA subjects in both parameters. Our findings suggested that sleep is important for the vascular function and health. Frequent sleep fragmentation and intermittent hypoxemia in severe OSA may lead to autonomic nervous dysfunction and vascular injury.