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자동형 양압유지기의 자동적정 알고리즘 개발

Development of Auto-titrating Algorithm for Auto-titrating Positive Airway Pressure

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초록

This study proposes an auto-titrating algorithm for auto-titrating positive airway pressure (APAP). The process of the proposed algorithm is as follows. First, sleep apnea-hypopnea and snoring events were detected using nasal pressure. Second, APAP base pressure and SDB events were used for automatic titration of optimal pressure. And, auto-titrating algorithm is built into M3 (MEK-ICS CO. Ltd., Republic of Korea) for evaluation. The detection results of SDB showed mean sensitivity (Sen.) and positive predictive value (PPV.) of 85.7% and 87.8%, respectively. The mean pressure and apnea-hypopnea index (AHI) of auto-titrating algorithm showed 13.0±5.2 cmH2O and 3.0±2.4 events/h, respectively. And, paired t-test was conducted to verify whether the performance of our algorithm has no significant difference with AutoSet S9 (p>0.05). These results represent better or comparable outcomes compared to those of previous APAP devices.

Abstract

This study proposes an auto-titrating algorithm for auto-titrating positive airway pressure (APAP). The process of the proposed algorithm is as follows. First, sleep apnea-hypopnea and snoring events were detected using nasal pressure. Second, APAP base pressure and SDB events were used for automatic titration of optimal pressure. And, auto-titrating algorithm is built into M3 (MEK-ICS CO. Ltd., Republic of Korea) for evaluation. The detection results of SDB showed mean sensitivity (Sen.) and positive predictive value (PPV.) of 85.7% and 87.8%, respectively. The mean pressure and apnea-hypopnea index (AHI) of auto-titrating algorithm showed 13.0±5.2 cmH2O and 3.0±2.4 events/h, respectively. And, paired t-test was conducted to verify whether the performance of our algorithm has no significant difference with AutoSet S9 (p>0.05). These results represent better or comparable outcomes compared to those of previous APAP devices.

참고문헌 (7)

  1. Collop N, "The effect of obstructive sleep apnea on chronic medical disorders", Cleve. Clin. J. Med, 74(1), pp.72~78 (2007)
  2. Prasad B, "Continuous positive airway pressure devicebased automated detection of obstructive sleep apnea compared to standard laboratory polysomnography", Sleep Breath, 14(2), pp.101~107 (2010)
  3. Sawyer AM, "LA systematic review of CPAP adherence across age groups : clinical and empiric insights for developing CPAP adherence interventions", SLEEP, 15(6), pp.343~356 (2011)
  4. Nigro CA, "Accuracy of a novel auto-CPAP device to evaluate the residual apnea-hypopnea index in patients with obstructive sleep apnea", Sleep Breath, 19(2), pp.569~578 (2015)
  5. Hirose M, "Bench study of auto-CPAP devices using a collapsible upper airway model with upstream resistance", Respir. Physiol. Neurobiol, 162(1), pp.48~44 (2008)
  6. Berry RB, "The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications" (2007), American Academy of Sleep Medicine
  7. Stammnitz A, "Automatic CPAP titration with different self-setting devices in patients with obstructive sleep apnoea", Eur. Respir. J, 24(2), pp.2073~2078 (2004)

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