The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Neil J. Douglas - One of the best experts on this subject based on the ideXlab platform.
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evaluation of a portable device for diagnosing the sleep apnoea hypopnoea syndrome
European Respiratory Journal, 2003Co-Authors: K Dingli, S.p. Finch, T. W. Mackay, E L Coleman, Marjorie Vennelle, P K Wraith, Neil J. DouglasAbstract:Waiting times for hospital-based monitoring of the obstructive sleep apnoea/hypopnoea syndrome (OSAHS) are rising. This study tested whether Embletta, a new portable device, may accurately diagnose OSAHS at home. A synchronous comparison to Polysomnography was performed in 40 patients and a comparison of home Embletta studies with in-laboratory Polysomnography was performed in 61 patients. In the synchronous study, the mean difference (Polysomnography–Embletta) in apnoeas+hypopnoeas (A+H)·h−1 in bed was 2·h−1. In comparison to the apnoea/hypopnoea index (AHI)·h−1 slept, the Embletta (A+H)·h−1 in bed differed by 8·h−1. These data were used to construct diagnostic categories in symptomatic patients from their Embletta results: “OSAHS” (≥20 (A+H)·h−1 in bed), “possible OSAHS” (10–20 (A+H)·h−1 in bed) or “not OSAHS” (<10 (A+H)·h−1 in bed). In the home study, the mean difference in (A+H)·h−1 in bed was 3·h−1. In comparison to the Polysomnographic AHI·h−1 slept, the Embletta (A+H)·h−1 in bed differed by 6±14·h−1. Using the above classification, all nine patients categorised as not OSAHS had AHI <15·h−1 slept on Polysomnography and all 23 with OSAHS on Embletta had an AHI ≥15 on Polysomnography, but 18 patients fell into the possible OSAHS category potentially requiring further investigation and 11 home studies failed. Most patients were satisfactorily classified by home Embletta studies but 29 out of 61 required further investigation. The study suggested a 42% saving in diagnostic costs over Polysomnography if this approach were adopted.
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use of home sleep studies for diagnosis of the sleep apnoea hypopnoea syndrome
Thorax, 1997Co-Authors: Adam T. Whittle, S.p. Finch, I L Mortimore, T. W. Mackay, Neil J. DouglasAbstract:BACKGROUND: A study was undertaken to test the hypothesis that unsupervised domiciliary limited sleep studies do not impair the accuracy of diagnosis when used to investigate the sleep apnoea/hypopnoea syndrome (SAHS) and can be cheaper than laboratory Polysomnography. METHODS: For validation, 23 subjects with suspected SAHS underwent laboratory Polysomnography and a home study (EdenTec 3711) on successive nights. All subjects with > 15 apnoeas + hypopnoeas (A + H)/hour on Polysomnography showed > 30 A + H/hour on their home study. Thereafter, in a prospective trial 150 subjects had a home study as the initial investigation and studies showing > 30 events/hour were regarded as diagnostic of SAHS. Those showing fewer events were investigated with Polysomnography if necessary. Time to treatment, outcome, and costs of this protocol were compared with those of 75 patients investigated initially with Polysomnography. RESULTS: Of the prospective trial subjects, 29% had > 30 A + H/hour and proceeded directly from home study to treatment; 15% without daytime sleepiness were not investigated further. Polysomnography was undertaken to establish a diagnosis in 56% of cases, including 18% whose home studies were unsuccessful. Compared with the 75 control patients, this protocol gave a diagnosis faster (median 18 (range 0-221) versus 47 (0-227) days, p < 0.001) and more cheaply (mean (SD) 164 pounds (104) versus 210 pounds (0), p < 0.001). The proportions offered CPAP (61% versus 67%) and subsequent objective CPAP usage (mean 4.7 (2.4) versus 5.0 (2.4) hours/night) were not different. CONCLUSIONS: Use of home sleep studies has benefits in time and cost. For diagnostic reliability a further sleep study was required in 56% of cases.
Jonathan A Bond - One of the best experts on this subject based on the ideXlab platform.
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movement toward a novel activity monitoring device
Sleep and Breathing, 2012Co-Authors: Hawley E Montgomerydowns, Salvatore P Insana, Jonathan A BondAbstract:Purpose Although Polysomnography is necessary for diagnosis of most sleep disorders, it is also expensive, time-consuming, intrusive, and interferes with sleep. Field-based activity monitoring is increasingly used as an alternative measure that can be used to answer certain clinical and research questions. The purpose of this study was to evaluate the reliability and validity of a novel activity monitoring device (Fitbit) compared to both Polysomnography and standard actigraphy (Actiwatch-64).
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movement toward a novel activity monitoring device
Sleep and Breathing, 2012Co-Authors: Hawley E Montgomerydowns, Salvatore P Insana, Jonathan A BondAbstract:Although Polysomnography is necessary for diagnosis of most sleep disorders, it is also expensive, time-consuming, intrusive, and interferes with sleep. Field-based activity monitoring is increasingly used as an alternative measure that can be used to answer certain clinical and research questions. The purpose of this study was to evaluate the reliability and validity of a novel activity monitoring device (Fitbit) compared to both Polysomnography and standard actigraphy (Actiwatch-64). To test validity, simultaneous Fitbit and actigraph were worn during standard overnight Polysomnography by 24 healthy adults at the West Virginia University sleep research laboratory. To test inter-Fitbit reliability, three participants also wore two of the Fitbit devices overnight at home. Fitbit showed high intradevice reliability =96.5–99.1. Fitbit and actigraph differed significantly on recorded total sleep time and sleep efficiency between each other and Polysomnography. Bland–Altman plots indicated that both Fitbit and actigraph overestimated sleep efficiency and total sleep time. Sensitivity of both Fitbit and actigraphy for accurately identifying sleep was high within all sleep stages and during arousals; specificity of both Fitbit and actigraph for accurately identifying wake was poor. Specificity of actigraph was higher except for wake before sleep onset; sensitivity of Fitbit was higher in all sleep stages and during arousals. The web-based Fitbit, available at a markedly reduced price and with several convenience factors compared to standard actigraphy, may be an acceptable activity measurement instrument for use with normative populations. However, Fitbit has the same specificity limitations as actigraphy; both devices consistently misidentify wake as sleep and thus overestimate both sleep time and quality. Use of the Fitbit will also require specific validation before it can be used to assess disordered populations and or different age groups.
Viviana Bompadre - One of the best experts on this subject based on the ideXlab platform.
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is there a correlation between sleep disordered breathing and foramen magnum stenosis in children with achondroplasia
American Journal of Medical Genetics Part A, 2016Co-Authors: Klane K White, Shawn E Parnell, Yemiserach Kifle, Marcella Blackledge, Viviana BompadreAbstract:Children with achondroplasia have midface hypoplasia, frontal bossing, spinal stenosis, rhizomelia, and a small foramen magnum. Central sleep apnea, with potential resultant sudden death, is thought to be related to compression of the spinal cord at the cervicomedullary junction in these patients. Screening Polysomnography and/or cervical spine MRI are often performed for infants with achondroplasia. Decompressive suboccipital craniectomy has been performed in selected cases. We aim to better delineate the relationship between Polysomnography, cervical spine MRI, and indications for surgical decompression in achondroplasia.We retrospectively review electronic medical records of all children with achondroplasia in our IRB-approved skeletal dysplasia registry who had received screening Polysomnography and cervical spine MRI examination was performed. We explored correlations of Polysomnography, MRI parameters, and need for decompressive surgery. Seventeen patients with both Polysomnography and MRI of the cervical spine met inclusion criteria. The average age at time of the sleep study was 2.4 ± 3.6 years. An abnormal apnea–hypopnea index was found in all patients, with central sleep apnea found in 6/17. Five patients (29%) required foramen magnum decompression. We found no statistically significant correlation between central sleep apnea and abnormal MRI findings suggestive of foramen magnum stenosis. Screening Polysomnography is an important tool but does not appear to correlate with MRI findings of foramen magnum stenosis. Cord compression, with either associated T2 cord signal abnormality or clinical findings of clonus, was most predictive of subsequent surgical decompression. © 2015 Wiley Periodicals, Inc.
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is there a correlation between sleep disordered breathing and foramen magnum stenosis in children with achondroplasia
American Journal of Medical Genetics Part A, 2016Co-Authors: Klane K White, Shawn E Parnell, Yemiserach Kifle, Marcella Blackledge, Viviana BompadreAbstract:Children with achondroplasia have midface hypoplasia, frontal bossing, spinal stenosis, rhizomelia, and a small foramen magnum. Central sleep apnea, with potential resultant sudden death, is thought to be related to compression of the spinal cord at the cervicomedullary junction in these patients. Screening Polysomnography and/or cervical spine MRI are often performed for infants with achondroplasia. Decompressive suboccipital craniectomy has been performed in selected cases. We aim to better delineate the relationship between Polysomnography, cervical spine MRI, and indications for surgical decompression in achondroplasia.We retrospectively review electronic medical records of all children with achondroplasia in our IRB-approved skeletal dysplasia registry who had received screening Polysomnography and cervical spine MRI examination was performed. We explored correlations of Polysomnography, MRI parameters, and need for decompressive surgery. Seventeen patients with both Polysomnography and MRI of the cervical spine met inclusion criteria. The average age at time of the sleep study was 2.4 ± 3.6 years. An abnormal apnea-hypopnea index was found in all patients, with central sleep apnea found in 6/17. Five patients (29%) required foramen magnum decompression. We found no statistically significant correlation between central sleep apnea and abnormal MRI findings suggestive of foramen magnum stenosis. Screening Polysomnography is an important tool but does not appear to correlate with MRI findings of foramen magnum stenosis. Cord compression, with either associated T2 cord signal abnormality or clinical findings of clonus, was most predictive of subsequent surgical decompression.
Salvatore P Insana - One of the best experts on this subject based on the ideXlab platform.
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movement toward a novel activity monitoring device
Sleep and Breathing, 2012Co-Authors: Hawley E Montgomerydowns, Salvatore P Insana, Jonathan A BondAbstract:Purpose Although Polysomnography is necessary for diagnosis of most sleep disorders, it is also expensive, time-consuming, intrusive, and interferes with sleep. Field-based activity monitoring is increasingly used as an alternative measure that can be used to answer certain clinical and research questions. The purpose of this study was to evaluate the reliability and validity of a novel activity monitoring device (Fitbit) compared to both Polysomnography and standard actigraphy (Actiwatch-64).
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movement toward a novel activity monitoring device
Sleep and Breathing, 2012Co-Authors: Hawley E Montgomerydowns, Salvatore P Insana, Jonathan A BondAbstract:Although Polysomnography is necessary for diagnosis of most sleep disorders, it is also expensive, time-consuming, intrusive, and interferes with sleep. Field-based activity monitoring is increasingly used as an alternative measure that can be used to answer certain clinical and research questions. The purpose of this study was to evaluate the reliability and validity of a novel activity monitoring device (Fitbit) compared to both Polysomnography and standard actigraphy (Actiwatch-64). To test validity, simultaneous Fitbit and actigraph were worn during standard overnight Polysomnography by 24 healthy adults at the West Virginia University sleep research laboratory. To test inter-Fitbit reliability, three participants also wore two of the Fitbit devices overnight at home. Fitbit showed high intradevice reliability =96.5–99.1. Fitbit and actigraph differed significantly on recorded total sleep time and sleep efficiency between each other and Polysomnography. Bland–Altman plots indicated that both Fitbit and actigraph overestimated sleep efficiency and total sleep time. Sensitivity of both Fitbit and actigraphy for accurately identifying sleep was high within all sleep stages and during arousals; specificity of both Fitbit and actigraph for accurately identifying wake was poor. Specificity of actigraph was higher except for wake before sleep onset; sensitivity of Fitbit was higher in all sleep stages and during arousals. The web-based Fitbit, available at a markedly reduced price and with several convenience factors compared to standard actigraphy, may be an acceptable activity measurement instrument for use with normative populations. However, Fitbit has the same specificity limitations as actigraphy; both devices consistently misidentify wake as sleep and thus overestimate both sleep time and quality. Use of the Fitbit will also require specific validation before it can be used to assess disordered populations and or different age groups.
Kevin D Pereira - One of the best experts on this subject based on the ideXlab platform.
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supraglottoplasty for laryngomalacia with obstructive sleep apnea
Laryngoscope, 2008Co-Authors: Mark Zafereo, Rodney J Taylor, Kevin D PereiraAbstract:Objectives/Hypothesis: To determine if supraglottoplasty (SGP) is effective in reversing abnormal respiratory parameters in children with laryngomalacia and obstructive sleep apnea (OSA). Study Design: Retrospective case series at a tertiary referral children's hospital. Methods: Ten patients with laryngomalacia and OSA as documented by Polysomnography underwent SGP between 2005 and 2007. Data collected included age, findings on flexible and rigid endoscopy, type of procedure performed, and postoperative course. The postoperative Polysomnographies were reviewed to identify changes in obstructive apnea index, obstructive apnea/hypopnea index, respiratory disturbance index, and low arterial oxygen saturation (O2 nadir) after SGP. Results: All 10 patients were successfully extubated after SGP. There were no peri- or postoperative complications, and no patient required a subsequent airway procedure. Each patient had a postoperative nocturnal Polysomnography performed after SGP at 11 weeks (range 2–29 weeks). Caregivers reported mild improvement (10%), significant improvement (70%), and complete resolution (20%) of stridor and nocturnal snoring at a follow-up visit 4 weeks after discharge. Marked improvements were observed in obstructive apnea index, obstructive apnea/hypopnea index, respiratory disturbance index and O2 nadir, all of which were statistically significant (P < .05). Conclusions: Polysomnography should be considered in the initial evaluation of infants with moderate laryngomalacia to rule out OSA. SGP is an effective treatment for infants with laryngomalacia and OSA. The significant benefits of the procedure outweigh thelow morbidity. Improvement after surgery was reliably confirmed by Polysomnography in this study.