Abstract

Abstract Introduction AASM recommends the use of nasal pressure (NP), oronasal thermal flow (TF), and respiratory inductance plethysmography (RIP) for detecting and characterising respiratory events in polysomnography. The use of both NP and TF sensors is reported to be more accurate in respiratory event identification than either alone. However, these sensors can be unreliable if dislodged and cause discomfort. Noxturnal calibrated RIP flow (cRIPflow), derived from RIP, may provide a non-invasive alternative method for flow measurement in identification of respiratory events. Method Respiratory scoring was performed manually by a single experienced scorer on 10 diagnostic sleep studies under AASM standards. Scoring was repeated using three different measurements for each study: cRIPflow only, Thermistor (Th) only and both Th+NP (AASM recommendation). Apnoea hypopnoea index (AHI), central apnoea index (CAI), obstructive apnoea index (OAI), mixed apnoea index (MAI) and hypopnoea index (HI) were calculated and paired t-test analysis utilised for comparison between measurements. Results No statistical differences were identified in comparison of cRIPflow with Th or Th+NP in respiratory event identification: CAI (cRIPflow 3.2/hr±7.1, Th 3.9/hr±8.9, Th+NP 3.1/hr±7.5), OAI (cRIPflow 6.1/hr±6.8, Th 5.3/hr±8.2, Th+NP 6.7/hr±8.9), MAI (cRIPflow 5.2/hr±9.7, Th 4.3/hr±8.7, Th+NP 4.7/hr±9.2), or HI (cRIPflow 12.5/hr±13.9, Th 11.1/hr±10.5, Th+NP 10.4/hr±10.7). There was a statistical difference for AHI (cRIPflow 26.9/hr±26.6, Th 24.5/hr±26.4, Th+NP 25.0/hr±26.5). Discussion This study suggests cRIPflow may provide an alternative measurement in the detection and characterisation of respiratory events, however further analysis with larger sample size would provide more insight into sensitivity and specificity of this method.

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