Night-time Monitoring Research Articles

Poligrafía respiratoria en el diagnóstico del síndrome de apneas obstructivas durante el sueño

The traditional way of diagnosing obstructive sleep apnea syndrome (OSAS) is all-night polysomnographic recording. A proposed alternative is respiratory polygraphy, a simplified procedure that consists in nighttime monitoring of oxygen saturation, oronasal flow and respiratory movements. Our aim was to evaluate the efficacy of respiratory polygraphy in diagnosing OSAS in comparison with conventional polysomnography. We studied 101 patients (92 men and 9 women) who had undergone polysomnography. An apnea-hypopnea index (AHI) > or = 10 was considered to be the diagnostic criterion for OSAS. To assess the diagnostic validity of respiratory polygraphy we considered that an AHI per hour of recording > or = 10 and a desaturation index per hour of recording > or = 10 were consistent with a diagnosis of OSAS. Sixty patients were diagnosed of OSAS. The AHI per hour of recording was > or = 10 in 56 patients, with 4 false negatives (sensitivity 93.3% and specificity 100%). The desaturation index per hour of recording was > or = 10 in 65 patients, with 7 false positives and 2 false negatives (sensitivity 96.6% and specificity 82.9%). We conclude that respiratory polysomnography is a specific, highly sensitive method for diagnosing OSAS.

Overnight vesical and rectal motility in children with vesico‐ureteral reflux

AbstractThe rectum and bladder are both innervated by the sympathetic and parasympathetic nervous system and have a close anatomical relation. In order to investigate whether a correlation between rectal and vesical activity is present we undertook the following study.Overnight pressure recordings from the bladder and the rectum were analyzed in 35 children with vesico‐ureteral reflux (VUR). The rectal activity of the VUR patients was compared to the rectal activity of 22 overnight recordings from normal children. The measurement system included bladder pressure measurement by way of fluid‐filled supra‐pubic catheters and rectal pressure measurement by a perfused open‐side hole catheter. Thirty‐two of the thirty‐five investigations were suitable for later computer analysis. The analysis program contained facilities for automatic scoring of contractions, frequency analysis, and area under curve determinations.Activity in the bladder and rectum was equally distributed between the reflux grades both regarding the number of contractions and the area under curve. Overnight number of contractions and the area under curve were correlated within the individual patient (σ = 0.80, P lt; 0.01). This indicates that the two variables equally reflect pressure activity. In patients with VUR rectal activity intensity were significantly correlated to bladder activity (σ = 0.53, P < 0.01). However, the number of rectal contractions in the patients were not significantly different from normals.It is concluded that the urodynamic pressure data can be analyzed using a computer‐aided method, providing a rapid and objective analysis of the data. Night‐time monitoring seems to reveal a general coherence between bladder and rectal motility in this category of patients. The nature of the relation between bladder and colo‐rectal activity needs further elucidation.