WO2015078082A1

WO2015078082A1 - Sleep breathing pathological typing method

Info

Publication number: WO2015078082A1
Application number: PCT/CN2013/090757
Authority: WO
Inventors: 张孝文; 宋丽娟; 金辉; 李燕妹; 李帅; 卢颖深
Original assignee: 张孝文
Priority date: 2013-11-27
Filing date: 2013-12-27
Publication date: 2015-06-04
Also published as: CN103622697A; CN103622697B

Abstract

Disclosed is a sleep breathing pathological typing method, comprising: obtaining the frequency of respiratory disorder events in a snoring interval during the sleep of a monitored person, wherein the snoring interval is a period from the end of a snore to the start of the next snore (S101, S201); and performing typing according to the frequency of respiratory disorder events in the snoring interval, wherein the respiratory disorder events comprise hypopnea and apnoea (S102, S202, S203, S204). The method performs the typing of snoring according to the frequency of respiratory disorder events in the snoring interval, closely connects snoring with breathing disorder events, makes the analysis of snoring more detailed and specific, enriches the research in the field of snoring, and lies the foundation for the diagnosis of sleep apnea hypopnea syndrom via snoring analysis.

Description

Description A sleep breathing pathological typing method

The invention relates to the field of medicine, and in particular to a method for typing a sleep respiratory pathology. Background technique

As early as 1837, the famous British novelist Charks Dickens (1812 - 1870) published a famous novel entitled "Pickwick's Biography", which described a name called Pickwick.

The fat boy (Pickwick Papers), who is short, obese, blushing, and lethargic, may be the earliest description of obstructive sleep apnea hypopnea syndrome (OSAHS). In 1906, William Oscar once wrote: There is a very special phenomenon among obese young people, which is the sleep tendency that is difficult to control, which is very similar to Divin's description of Pickwick. In 1918, Olser described an obesity, lethargy, and cyanosis syndrome, named Pickwick syndrome. In China, Zhang Zhongjing of the Eastern Han Dynasty introduced the concept of snoring in the "Treatise on Febrile Diseases. Article 6" (200-210 AD) for the first time. In Chinese classical literature, there is also a vivid description of snoring. In the forty-fifth round of "The Romance of the Three Kingdoms", "Sanjiangkou Cao Cao Folding Soldiers, the Great League will be Jiang Ganzhong" wrote: "Yu and clothes lay down, vomiting wolves. How does Jiang Gan sleep?" Got it? ..., when watching Zhou Yu, the breath is like a thunder."

In the forty-first back of "Dream of Red Mansions", "Jia Baoyu Tea Tea Jade, Liu Yi drunk, lying in the red courtyard" wrote: "The attacker entered the door..., I heard (Liu Wei) 鼾驹如雷, I am busy coming in, only to smell the smell of alcohol."

"Liao Zhai Zhiyi" "Nie Xiaoqian" wrote: "Yan takes the box and puts it on the window. When the pillow is moved, it is like a thunder, but it can't be smashed." The breath mentioned in the book, oh, is the sound of snoring, and the snoring sounds like a thunder. Literature The description of warfare is much longer than human research on snoring.

Sleep apnoea syndrome (SAS) was confirmed in sleep apnea syndrome (SAS) during 1960 and 1980, and snoring was considered to be the most important symptom of SAS until the American Sleep Disorder Association (ASDA) defined snoring as "loud upper respiratory tract breathing, without breathing Suspension or lack of lung ventilation, caused by pharyngeal tissue vibration, and said that based on frequency, position and interference with others (spouse, bed partner) can be divided into mild, moderate or severe.

It is now believed that snoring is the earliest, most prominent, and audible characteristic symptom of OSAHS patients. (hallmark). The study of the mechanism and acoustic characteristics of snoring originated in the 1980s. Heavy, stable, regular or irregular, continuous or intermittent, apnea, after apnea, or without apnea, etc. Reported in the literature. The naming of snoring is more confusing and is not conducive to clinical and scientific research.

Studies have shown that patients with 0SAHS and simple snore (SS) have different acoustic characteristics, which may help distinguish between the two. The so-called simple snoring refers to the absence of respiratory turbulence after snoring, and the characteristics of the snoring of respiratory disorders after snoring are currently lacking in research. If you ignore the simple snoring in 0SAHS, at least 85% of sleep breathing information will be overestimated or inaccurate. If you know that a simple snoring exists in OS AHS, use other snoring as an analysis, ignoring at least 10% of respiratory disorders. In recent years, foreign scholars have paid attention to the analysis of the characteristics of snoring during the snoring. Some scholars have noticed that the interval of snoring in OSAHS patients (from the beginning of snoring to the beginning of the next snoring) is significantly shorter than that of normal snorers. However, the length of the snoring interval is only a sign indicating that the core is the sleep event, but scholars have not yet studied the characteristics of sleep events during different snoring. Therefore, we believe that the existence of sleep events during the neglect of snoring may be the reason why the accuracy of OSAHS is not high. Summary of the invention

The technical problem to be solved by the present invention is to provide a sleep breathing pathological typing method which can closely combine the snoring and breathing disorder events.

In order to solve the above technical problem, the present invention provides a sleep breathing pathological typing method, comprising: obtaining a number of occurrences of a respiratory disorder event during a sleep interval of a monitored person during a sleep period, wherein the click interval is a beep end Beginning with the next snoring, the respiratory disorder event includes hypopnea, apnea; and typing according to the number of occurrences of the respiratory disorder during the snoring interval.

As an improvement of the above solution, the method for typing according to the number of occurrences of a respiratory disorder during a snoring interval includes: dividing a situation in which no respiratory disorder occurs during a snoring interval into a snoring type I; The case of a respiratory disorder is divided into a snoring type II; the occurrence of two or more respiratory disorders during the interval of the snoring is divided into a snoring type.

As an improvement of the above scheme, the snoring type III is further divided into a plurality of snoring types according to the number of occurrences of the breathing disorder event during the interval of the squeaking, so that the different occurrence times correspond to different snoring types.

As a modification of the above scheme, the hypopnea means that the respiratory airflow during sleep is reduced by more than 50% of the normal airflow intensity accompanied by a decrease in 3% oxygen saturation. As an improvement of the above solution, the sleep apnea means that the airflow of the mouth and the nose are stopped during sleep.

More than 10 seconds.

The implementation of the present invention has the following beneficial effects:

On the basis of summarizing the sleep monitoring data, the snoring is creatively classified according to the number of occurrences of respiratory disturbances during the interval of the snoring, and the snoring and respiratory disorders are closely combined to enrich the research in the field of snoring.

Among them, combined with the experiment, the situation of no respiratory disorder during the interval of the snoring is divided into snoring

Type I, which divides the occurrence of a respiratory disorder during the interval of the snoring into a snoring type II, and divides the occurrence of two or more respiratory disturbances during the interval of the snoring into a snoring type III, which makes the analysis of the snoring more Detailed and specific, it improves the accuracy of snoring analysis and diagnosis of OSAHS, and provides scientific basis for enriching the research of OSAHS snoring and accurate diagnosis of OSAHS based on snoring detection. DRAWINGS

1 is a flow chart of a method for typing a sleep breathing pathology according to the present invention;

2 is another flow chart of a method for typing a sleep breathing pathology of the present invention. detailed description

The present invention will be further described in detail below with reference to the accompanying drawings.

1 is a flow chart of a method for typing a sleep breathing pathology according to the present invention, comprising:

5101. Obtain the number of occurrences of respiratory disorders during the interval between the beeps of the monitored person during sleep.

The click interval is from the end of one click to the start of the next click.

The respiratory disorder event includes hypopnea, apnea.

More preferably, the hypoventilation means that the respiratory airflow during sleep decreases by more than 50% of the normal airflow intensity with a 3% decrease in blood oxygen saturation.

More preferably, the sleep apnea means that the airflow of the mouth and the nose are stopped for more than 10 seconds during sleep.

5102. Perform typing according to the number of occurrences of a respiratory disorder during the interval of the snoring.

It should be noted that, if the study is to ignore the simple snoring in 0SAHS, at least 85% of the sleep breathing information will be overestimated or inaccurate, if you know the simple snoring in 0SAHS At the other end of the snoring, at least 10% of respiratory disorders are ignored. Therefore, the number of occurrences of respiratory disorders during the interval of the snoring is detected, and the number of occurrences of the respiratory disorder is classified according to the number of occurrences of the snoring interval, so that the snoring and the respiratory disorder are closely combined to enrich

OSAHS vocal research and accurate diagnosis based on snoring detection OSAHS provides scientific evidence.

2 is another flow chart of a sleep breathing pathological typing method of the present invention, including:

5201. Obtain the number of occurrences of a respiratory disorder during the interval between the beeps of the monitored person during sleep.

The click interval is from the end of one click to the start of the next click.

The respiratory disorder event includes hypopnea, apnea.

5202, the situation in which no respiratory disorder occurred during the interval of the snoring is divided into a snoring type I.

5203. Divide a respiratory disorder event into a snoring type II.

5204. Dividing the occurrence of two or more respiratory disorders during the interval of the snoring into the snoring type III.

The invention will be further described in detail below with reference to specific embodiments.

Example:

1. Research object

From October 2010 to December 2011, due to snoring in the Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Guangzhou Medical College, all patients were diagnosed with OSAHS because of snoring. All patients went to the sleep center for overnight polysomnography. According to the test requirements, Patients who did not complete the trial arrangement and failed to monitor were excluded.

Exclusion criteria:

(1) suffering from 'I" Man's] "healing obstruction"] "chronic obstructive pulmonary disease (COPD), monthly hypertension, pneumonia and other lung diseases that can cause hypoxia;

(2) suffering from thoracic deformity, neuromuscular disease;

(3) Central and mixed sleep apnea hypopnea syndrome;

(4) Previous treatments for OSAS, continuous positive airway pressure, orthodontic appliances;

(5) Total sleep time is less than 4 hours:

(6) The PSG data is incomplete due to the falling of the monitoring lead during the monitoring process. 2. Research instruments

PSG uses the Alice4 sleep monitoring system from Respironics, USA. The monitoring parameters include electroencephalogram (EEG), electrooculogram (EOG), electromyography (EMG), nasal and nasal airflow, chest and abdomen respiratory motion amplitude, electrocardiogram, and percutaneous Peripheral oxygen saturation, snoring, sleep position, etc., the patient's monitoring time in the sleep center is from 22:00 to 7:00 the next day.

3, PSG monitoring parameter setting

Data analysis was performed according to the American Academy of Sleep Medicine (AASM) standards. According to EEG, EO, sleep phase staging; hypopnea and apnea events based on airflow; sleep apnea index (AHI) refers to the average number of apneas and hypopneas per hour of sleep. The diagnostic criteria for adults (AHK 5 times/hour) determined by the American Sleep Medicine Association in 1999 were selected. AHI was mild at 5 to 14 times/hour, moderate at 15 to 29 times/hour, and severe at >30 times/hour. AHI <5 times / hour for hysteria.

4, statistical methods

All data were processed by SPSS1. 0 statistical software, and the correlation was analyzed by Pearson method. P<0.05 was statistically significant.

5, the results

After exclusion of 160 snoring patients, a total of 148 patients completed the study, including 124 patients with OSAHS, a total of 41,329 snoring intervals; 24 patients with snoring alone, a total of 4813 snoring intervals.

Correspondingly, the basic situation of patients is shown in Table 1.

Table I

I snoring and basic conditions of patients with mild, moderate and severe OSAHS I snoring mild moderate severe

OSAHS OSAHS OSAHS

Number of cases 24 24 23 77

Gender (female/male) 10/14 11/13 5/18 10/67 Age 46.54 士48.21 + 48.22士50.44士

11.87 13.03 16.50 12.74

AHI (time / hour) 9.68 + 21.00 ± 61.30 +

2.85 4.85 18.65 No breathing occurred during the interval of snoring 178.79 ± 230.63 ± 205.13 + 152.35 ± chaotic events (times) 155.28 174.54 183.54 155.06 A breathing occurred during the interval of the snoring 17.42 士 31.57 士 66.32 士 disorder (times) inch i' 20.92 32.22 66.38 Two times and two to

16.88 +1

1+ ± 31.00 + 37.91 ± 149.14 + more than one respiratory disorder (times) 16.90 25.89 30.18 109.81 As can be seen from Table 1, the sleep events during the snoring interval are mainly:

1. Continuous snoring, no respiratory disorder occurred during the interval between snoring;

2. Only one respiratory disorder occurs during the interval between snoring, that is, hypopnea or apnea;

3. Two or more respiratory disorders occur during the interval between snoring, that is, hypoventilation, apnea, repeated or repeated.

Moreover, among 128 patients with OSAHS, there were 41329 vocal intervals, 53.18% of those without respiratory disturbances during the interval of snoring, 15.12% of those with respiratory disturbances during the interval between snoring, and twice and twice during the interval between snorings. The above respiratory disorders accounted for 31.70%; 24 of the 24 patients with simple snoring, a total of 4813 snoring intervals, 89.15% of the occurrence of respiratory disturbances during the interval between snoring, and 2.43% of the occurrence of respiratory disturbances during the interval between snoring, snoring Two or more respiratory disorders occurred during the interval, accounting for 8.42%.

According to the correlation, the Pearson method is used to analyze, among which:

There was no respiratory disorder in the AHI and snoring interval of OSAHS patients (p=0.010), a respiratory disorder occurred during the interval between snoring (p<0.001), and two or more respiratory disorders occurred during the interval between snoring (p <0.001) are all relevant. At the same time, as shown in Table 1, the more times the OSAHS patients have snoring intervals, the more snoring times, the more severe the OSAHS level. The more times there are no respiratory disorders during the interval between snoring, the less the degree of OSAHS in patients. a respiratory disorder occurred during the interval between snoring The number of times, two or more occurrences of respiratory disorders during the interval between snoring determines the severity of OSAHS.

Correspondingly, AHI in patients with simple snoring was only associated with a respiratory disorder during the interval between snoring (p<0.001), and the number of snoring intervals, the number of non-respiratory events during the interval between snoring, and the interval between snorings. The number of occurrences of two or more respiratory disorders was irrelevant.

It can be seen from the above that during the snoring period of OSAHS patients: 1. No respiratory disorder occurred during the interval of snoring; 2. Only one respiratory disorder occurred during the interval of snoring; 3. Two or more respiratory disturbances occurred during the interval between snoring event. Correspondingly, the sleep apnea index AHI is an indicator for judging the severity. In the interval of snoring with respiratory disorders, only 32.04% of the occurrence of a respiratory disorder occurred, and 67.96 occurred two or more respiratory disorders. %. That is, the incidence of snoring intervals in non-respiratory disorder events is high, and the number of snoring intervals in secondary and multiple respiratory disorders is objectively present and more than the number of snoring intervals in a single respiratory disorder event. Therefore, after neglecting simple snoring in OSAHS patients, OSAHS patients have a higher incidence of two or more respiratory disorders after snoring, and the presence of these phenomena after snoring is the reason for the low accuracy of snoring analysis for OSAHS. It can be seen that the classification is based on the number of occurrences of the respiratory disorder during the interval of the snoring, that is, the situation in which no respiratory disorder occurs during the interval of the snoring is divided into a snoring type I, and a respiratory disorder occurs during the interval of the snoring. The situation is divided into snoring type II, which divides the occurrence of two or more respiratory disorders during the interval of snoring into snoring type III, which can closely combine snoring and respiratory disorders, and is creative based on summarizing sleep monitoring data. The new type of humming, rich in the field of humming, will lay a solid foundation for the study of accurate diagnosis of OSAHS and snoring based on snoring analysis.

More preferably, the snoring type III is further divided into a plurality of snoring types according to the number of occurrences of the breathing disorder during the interval of the squeaking, so that the number of occurrences corresponds to different types of snoring.

Therefore, according to the actual situation, the type of hum can be increased to make the classification more detailed and specific.

For example, the situation of two respiratory disorders occurring during the interval of the snoring is divided into a snoring type, and the occurrence of three respiratory disorders during the interval of the snoring is divided into a snoring type IV, and four breathing disorders occur during the interval of the snoring. The situation is divided into a buzzing V-type, and so on.

Preferably, the sleep disordered breathing event may also include respiratory effort according to international sleep standards. Respiratory-effort related arousals (RERAs)

The above is a preferred embodiment of the present invention, and it should be noted that those skilled in the art can also make several improvements and retouchings without departing from the principles of the present invention. These improvements and retouchings are also considered. It is the scope of protection of the present invention.

Claims

1. A sleep breathing pathology classification method, characterized by including:

Obtain the number of occurrences of breathing disorder events during the snoring interval of the monitored person during sleep. The snoring interval is from the end of one snoring to the beginning of the next snoring. The breathing disorder events include hypoventilation and apnea;

Classification is carried out based on the number of respiratory disorder events occurring during the snoring interval.

2. The method for typing sleep breathing pathology according to claim 1, wherein the method of typing based on the number of occurrences of respiratory disorder events during the snoring interval includes:

Snoring without respiratory disturbance events during the snoring interval is classified as snoring type I;

The occurrence of a respiratory disorder event within the snoring interval is classified as snoring type II;

The occurrence of two or more respiratory disturbance events within the snoring interval is classified as snoring type ΠΙ.

3. The sleep breathing pathology classification method according to claim 2, characterized in that the snoring type III is further divided into multiple snoring types according to the number of occurrences of respiratory disorder events during the snoring interval, so that different occurrence times Corresponds to different snoring types.

4. The sleep breathing pathology classification method according to any one of claims 1 to 3, characterized in that the hypoventilation refers to a reduction in respiratory airflow during sleep that exceeds more than 50% of the normal airflow intensity and is accompanied by 3% Blood oxygen saturation drops.

5. The sleep breathing pathology classification method according to any one of claims 1 to 3, characterized in that the sleep apnea refers to the cessation of oral and nasal airflow for more than 10 seconds during sleep.