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P092 Automation in Equipment Asset Management for Laboratory Efficiencies 实验室效率的设备资产管理自动化
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.177
C Hartnett, A Kevat, G Williams
Abstract Introduction Asset management of laboratory equipment is essential to patient safety. Traceability enables any patient affected by equipment that has been recalled, or subsequently been found faulty, to be retested. Sleep equipment in home, ward or laboratory needs to be clearly documented but this paperwork is tedious and manual. Methods A portable barcode scanner with software was added to the laboratory asset management and the time efficiencies were evaluated. Results The time reduction of using a barcode scanner to manual data entry was found to decrease time approximately fourfold, from 8 mins (std 1.5mins) to 2.2 mins (std 0.5mins). This is for each sleep laboratory testing bed and can equate to 35 minutes in a six-bed sleep laboratory. Accuracy of data is assured with a barcode scanner, compared to manual input. Discussion Using automation to replace manual tasks in a sleep laboratory saves time and ensures data accuracy. Further advances in automation for tagging medical devices would improve this in areas with high use of home or ward devices.
实验室设备的资产管理对患者安全至关重要。可追溯性使任何受召回设备影响的患者,或随后被发现有缺陷的患者,都可以进行重新测试。家庭、病房或实验室的睡眠设备需要清楚地记录,但这些文书工作繁琐且需要手工完成。方法在实验室资产管理中增加便携式条码扫描器,并对其时间效率进行评价。结果使用条码扫描器手动输入数据的时间减少了大约四倍,从8分钟(标准1.5分钟)减少到2.2分钟(标准0.5分钟)。这是为每个睡眠实验室测试床,相当于35分钟在六床睡眠实验室。与人工输入相比,使用条形码扫描器可以保证数据的准确性。在睡眠实验室中使用自动化代替人工任务,既节省了时间,又保证了数据的准确性。医疗设备标签自动化的进一步发展将在家庭或病房设备使用率高的地区改善这一点。
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引用次数: 0
P070 Efficacy of the ExVent Accessory with the O2Vent Optima Oral Appliance in the Treatment of Obstructive Sleep Apnea – A Clinical Trial ExVent配件联合O2Vent Optima口腔矫治器治疗阻塞性睡眠呼吸暂停的临床研究
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.155
S Sharma, H Reiter, A Conflitti
Abstract Introduction The study assessed the efficacy of oral appliance device O2Vent Optima and ExVent, an oral Expiratory Positive Airway Pressure (EPAP) accessory in the treatment of OSA. Methods A prospective, open-label study conducted at 3 sites in mild to moderate OSA (AHI ≥ 5 and ≤ 30). Screening Phase A diagnostic in-lab PSG study confirmed a diagnosis of mild to moderate OSA. Treatment I Subjects used O2Vent Optima for 6 weeks and underwent a PSG sleep night while using the O2Vent Optima. Treatment II Subjects used O2Vent Optima + ExVent for 6 weeks and underwent a PSG sleep night while using the O2Vent Optima + ExVent Primary Effectiveness Measure: Change in AHI between baseline vs. O2Vent Optima MAD vs. O2Vent Optima + ExVent Results Treatment with Optima, Optima + ExVent reduced AHI from 22.5±6.4/hr to 12.6±4.5/hr to 5.9±2.7 (p< 0.005 baseline vs. Optima and Optima + ExVent; p<0.05 Optima MAD vs. Optima + ExVent). Average reduction in AHI with Optima was 43% and with Optima + ExVent was 72%. The lowest oxygen during sleep increased from 84.6±2.7% to 88.6±2.9% to 91.6±3.2% (p< 0.005 baseline vs. Optima and Optima + ExVent; p<0.05 Optima vs. Optima + ExVent). During the trial patients on treatment with Optima and Optima + ExVent demonstrated no excessive adverse events or device malfunction. Conclusion Treatment with O2Vent Optima and O2Vent Optima + ExVent significantly improved OSA compared to the baseline. Even greater benefit was observed with addition of ExVent to the Optima in mild to moderate OSA.
摘要:本研究评估了口腔器械O2Vent Optima和口腔呼气正压通气(EPAP)辅助装置ExVent治疗OSA的疗效。方法在3个轻中度OSA患者(AHI≥5和≤30)进行前瞻性、开放标签研究。筛查A期诊断性实验室PSG研究证实了轻度至中度OSA的诊断。治疗一:受试者使用O2Vent Optima 6周,并在使用O2Vent Optima的同时进行PSG睡眠。治疗II受试者使用O2Vent Optima + ExVent治疗6周,并在使用O2Vent Optima + ExVent主要有效性测量方法的同时进行PSG睡眠夜:基线与O2Vent Optima的AHI变化与O2Vent Optima的AHI变化与O2Vent Optima + ExVent结果相比,Optima + ExVent将AHI从22.5±6.4/小时降低到12.6±4.5/小时至5.9±2.7 (p<基线vs Optima和Optima + ExVent 0.005;p<0.05 Optima MAD vs. Optima + ExVent)。Optima的平均AHI降低率为43%,Optima + ExVent的平均AHI降低率为72%。睡眠时最低含氧量由84.6±2.7%上升至88.6±2.9%,再上升至91.6±3.2% (p<基线vs Optima和Optima + ExVent 0.005;p<0.05 Optima vs. Optima + ExVent)。在试验期间,接受Optima和Optima + ExVent治疗的患者没有出现过多的不良事件或设备故障。结论与基线相比,O2Vent Optima和O2Vent Optima + ExVent治疗可显著改善OSA。在轻度至中度OSA患者中,在Optima的基础上加入ExVent,观察到更大的益处。
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引用次数: 0
O078 A Comparison of Subjective Sleepiness and Subjective driving Performance between People Vulnerable Versus Resistant to Driving Impairment following Extended Wakefulness. [078]长时间清醒后易受伤害与抵抗性驾驶损伤者主观嗜睡与主观驾驶表现的比较。
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.078
K Nguyen, C Dunbar, A Guyett, K Bickley, P Nguyen, H Scott, A Reynolds, M Hughes, R Adams, L Lack, P Catcheside, J Cori, M Howard, C Anderson, D Stevens, N Lovato, A Vakulin
Abstract Introduction Subjective sleepiness and driving performance are generally associated but show inter-individual variability. Specifically, some people are more vulnerable, while others are more resistant to driving impairment during extended wakefulness. We examined the relationship between subjective sleepiness and driving performance in groups resistant versus vulnerable to driving impairment during extended wakefulness. Methods Thirty-two adults (female=18, mean age=33.0yrs, SD=14.6) completed five 60-minute driving simulator assessments across 29 hours of extended wakefulness. Perceived sleepiness (Karolinska sleepiness scale, KSS) and driving performance (nine-point Likert scale) were assessed at 10-minute intervals while driving. Through cluster analysis, participants were categorised as vulnerable (n=16) or resistant (n=16) using steering deviation and crash data. Correlations, stepwise regressions, and ROC curves were used to identify predictors of driving impairment. Results Perceived sleepiness and driving impairment increased across the drives during wakefulness and within drives, regardless of grouping (p<0.001). The exception was the drive at 25-hours into wakefulness, where the vulnerable group showed higher perceived driving impairment within the drive (p=0.001). Pre-drive KSS, total sleep time, age and gender were not significant predictors of crashes at drives undertaken at 1-hour, 7-hours, 13-hours, or 25-hours, but were significant at 19-hours into wakefulness, together explaining 44% of the variance in crashes. Discussion Self-reports are sensitive to driving impairment but not differential vulnerability to performance decrements during extended wakefulness. However, the findings support that both groups can perceive their sleepiness and ideally employ appropriate countermeasures (e.g., stop driving, nap, caffeine). Future studies should target more objective predictors of vulnerable versus resistant groups.
主观嗜睡与驾驶表现普遍相关,但存在个体差异。具体来说,有些人更容易受到伤害,而另一些人在长时间清醒时更能抵抗驾驶障碍。我们研究了在长时间清醒状态下抵抗和易受驾驶障碍影响的组中,主观嗜睡和驾驶表现之间的关系。方法32名成人(女性18岁,平均年龄33.0岁,SD=14.6)在29小时的延长清醒状态下完成5次60分钟的驾驶模拟器评估。在驾驶过程中,每隔10分钟评估一次感知困倦(卡罗林斯卡困倦量表,KSS)和驾驶表现(李克特九分量表)。通过聚类分析,使用转向偏差和碰撞数据将参与者分类为脆弱(n=16)或抵抗(n=16)。使用相关性、逐步回归和ROC曲线来确定驾驶障碍的预测因子。结果:无论分组如何,在清醒状态和驾驶过程中,感知到的困倦和驾驶障碍在驾驶过程中都有所增加(p<0.001)。例外是在清醒25小时的驾驶中,弱势群体在驾驶过程中表现出更高的感知驾驶障碍(p=0.001)。开车前的KSS、总睡眠时间、年龄和性别在开车1小时、7小时、13小时或25小时时并不是撞车事故的显著预测因子,但在清醒后的19小时时则是显著的,它们共同解释了撞车事故的44%方差。自我报告对驾驶障碍敏感,但对长时间清醒状态下性能下降的差异脆弱性不敏感。然而,研究结果表明,两组人都能意识到自己的困倦,并采取适当的对策(例如,停止开车、小睡、咖啡因)。未来的研究应该针对更客观的易感人群和耐药人群的预测指标。
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引用次数: 0
O072 Simple Vestibular-Occular Motor Assessment as a Predictor of Alertness State and Driving Impairment during Extended Wakefulness 简单前庭-眼运动评估作为长时间清醒状态下警觉状态和驾驶障碍的预测因子
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.072
P Nguyen, C Dunbar, A Guyett, K Nguyen, K Bickley, A Reynolds, M Hughes, H Scott, R Adams, L Lack, P Catcheside, J Cori, M Howard, C Anderson, N Lovato, A Vakulin
Abstract Introduction Driver fatigue contributes to 2-16% of road crashes, highlighting the need for improved detection of at-risk drivers. We used a novel and brief test of vestibular ocular motor system (VOMS) assessed via virtual reality goggles to predict alertness state and driving simulator performance during 29hr extended wakefulness. Methods 49 individuals (Mean±SD Age, 32.6±12.9, 45% Males) undergone 9hr baseline sleep opportunity followed by ~29hrs extended wakefulness with five 60min driving assessments. Cluster analysis, combining steering deviation and number of crashes were used to split participants into groups of either poor vs good driving performance. VOMS assessment was conducted using virtual reality goggles approximately 10mins before and after each drive. Predictive importance of VOMs metrics were ranked using XGBoost machine learning model, which was then utilized to distinguish between poor vs good driving groups. Model performance was evaluated using a 5-fold cross-validation approach using ROC analysis. Results XGBoost machine learning ranked all 70 VOMS metrics on their importance in predicting driving performance group for each drive. Top 10 metrics from pre-drive VOMS test predicted both daytime driving (tests 1-3, AUC 0.8 [95%CI 0.64-0.93], p&lt;0.001) and night-time driving (tests 4-5, AUC 0.78 [95%CI 0.6-0.95, p&lt;0.001]). Post-driving VOMS assessments also predicted daytime (AUC 0.74 [95%CI 0.53-0.9, p&lt;0.001] and night-time driving (AUC 0.76 [95%CI 0.52-0.94, p&lt;0.001]). Conclusion VOMS assessment show promise as a short and effective assessment of sleepiness to predict driving failure. Future validation in independent samples, sleep disordered population and in-field on-road testing are needed to confirm these promising findings.
驾驶员疲劳造成了2-16%的道路交通事故,强调了提高对危险驾驶员的检测的必要性。我们使用了一种新颖而简短的前庭眼运动系统(VOMS)测试,通过虚拟现实护目镜评估,来预测29小时延长清醒状态下的警觉性状态和驾驶模拟器的性能。方法49例受试者(平均±SD年龄,32.6±12.9,男性占45%)基线睡眠时间9小时,延长清醒时间~29小时,进行5次60min驾驶评估。聚类分析,结合转向偏差和撞车次数,将参与者分为驾驶性能差和驾驶性能好的两组。在每次驾驶前后约10分钟使用虚拟现实护目镜进行VOMS评估。使用XGBoost机器学习模型对VOMs指标的预测重要性进行排名,然后利用该模型区分差和好的驾驶组。采用5倍交叉验证方法对模型性能进行评估,并采用ROC分析。XGBoost机器学习将所有70个VOMS指标根据其在预测每个驱动器的驾驶性能组中的重要性进行排名。驾驶前VOMS测试的前10个指标预测了白天驾驶(测试1-3,AUC 0.8 [95%CI 0.64-0.93], p<0.001)和夜间驾驶(测试4-5,AUC 0.78 [95%CI 0.6-0.95, p<0.001])。驾驶后VOMS评估也预测了白天(AUC 0.74 [95%CI 0.53-0.9, p<0.001])和夜间驾驶(AUC 0.76 [95%CI 0.52-0.94, p<0.001])。结论VOMS评价是一种预测驾驶失误的快速有效的评价方法。未来需要在独立样本、睡眠障碍人群和现场道路测试中进行验证,以证实这些有希望的发现。
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引用次数: 0
P088 The Relationship between Screen time, Sleep, and Language Development in Pre-school Aged Children 学龄前儿童屏幕时间、睡眠和语言发展的关系
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.173
M Gale, E Axelsson, A Eidels, A Robson, J Mace
Abstract An increasingly prevalent factor in the preschool years is screen time, with possible implications for sleep and development. Few studies have simultaneously assessed screen time, sleep, and development. I aim to investigate preschoolers’ screen time, sleep, and language development, alongside predictors of screen time, social behaviours, and how sleep supports long-term memory for new words. Screen time durations for educational, entertaining, and relaxing content types, will be recorded over three days. This is to assess whether content types have differing relationships with sleep. If sleep quality and duration are impeded, this may create a cyclical pattern between sedentary behaviour, sleep, and screen time. I will also measure screen times at differing times of the day, and the percentage of time spent interacting with another person or the screen content. Children will be exposed to new words at the beginning of the study and their memory will be tested after three nights. Importantly, assessing the interaction between screen time and sleep, in relation to children’s memory for the new words. Sleep will be measured using actigraphy watches and a sleep diary. Standardised measures of vocabulary and communication will be used to assess children’s language development. As language development is a multifaceted process, assessing predictors, social behaviours, and memory for new words, allows assessment of factors that may benefit or hinder sleep and language development. This comprehensive study will contribute to the understanding of the relationships between screen time, sleep, and language development, and the nuanced factors that relate to its success.
学龄前儿童看屏幕的时间越来越普遍,这可能会影响睡眠和发育。很少有研究同时评估屏幕时间、睡眠和发育。我的目标是调查学龄前儿童的屏幕时间、睡眠和语言发展,以及屏幕时间、社会行为和睡眠如何支持新单词的长期记忆的预测因素。教育、娱乐和放松类型的屏幕时间将在三天内记录下来。这是为了评估内容类型是否与睡眠有不同的关系。如果睡眠质量和持续时间受到阻碍,这可能会造成久坐行为、睡眠和屏幕时间之间的循环模式。我还将测量一天中不同时间的屏幕时间,以及与他人或屏幕内容互动的时间百分比。孩子们将在学习之初接触到新单词,三晚后测试他们的记忆力。重要的是,评估屏幕时间和睡眠之间的相互作用,与儿童对新单词的记忆有关。睡眠将通过活动记录表和睡眠日记进行测量。词汇和交流的标准化测量将被用来评估儿童的语言发展。由于语言发展是一个多方面的过程,评估预测因素、社会行为和对新单词的记忆,可以评估可能有利于或阻碍睡眠和语言发展的因素。这项全面的研究将有助于理解屏幕时间、睡眠和语言发展之间的关系,以及与成功相关的微妙因素。
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引用次数: 0
P099 Use of Digital Technology During Child Bedtime Routines: A qualitative investigation 儿童就寝时间使用数字技术:一项定性调查
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.184
J McKenzie, C Pattinson, K Rossa, S Edmed, A Loeffler, S Smith
Abstract Introduction The Child Bedtime Routines Study (CBRT) sets out to examine patterns and attitudes towards sleep in daily life in a novel and detailed way, by constructing personal timelines of 5–8-year-old children’s sleep routines in their homes, their digital technology use, and parental attitudes and behaviours surrounding sleep and digital technology use. Methods This project involved individual semi-structured interviews with 30 parents of 5–8-year-old children via zoom. During the interview parents completed a novel visualisation of their home environment and the visual diagramming tasks for afternoon and evening, sleep and wake routines at home via the online interactive platform Mural. Results Thirty parents (Female = 86.7%) of 30 children (66.7% boys) aged between 5 and 8 years participated in the study. The most common description of their child using technology was watching shows or videos via tv or tablet. Over 76% of parents identified having rules or regulations regarding digital technology use. There was little technology use reported around bed-time routines, however, the use of apps to listen to bedtime stories was reported by some. Discussion The interviews allowed for greater description and nuance regarding the parenting decisions around technology use in the home. Household rules around the use of digital technology by children were not specifically oriented around bedtime or the potential impact of technology on sleep quality, duration, or timing. The use of technology-based sleep aids may increase, and a better understanding of the potential benefits and costs of those technologies needs to be understood.
儿童就寝习惯研究(CBRT)通过构建5 - 8岁儿童在家中的睡眠习惯、他们对数字技术的使用以及父母对睡眠和数字技术使用的态度和行为的个人时间表,以一种新颖而详细的方式来研究日常生活中的睡眠模式和态度。方法采用半结构化访谈法对30名5 ~ 8岁儿童家长进行访谈。在采访中,家长们通过在线互动平台壁画完成了一项新颖的家庭环境可视化任务,以及下午和晚上在家里睡觉和起床的可视化任务。结果30名5 ~ 8岁儿童(男孩占66.7%)的家长30名(女性占86.7%)参与研究。对孩子使用科技产品最常见的描述是通过电视或平板电脑看节目或视频。超过76%的家长表示,他们在使用数字技术方面有规章制度。据报道,在就寝时间使用科技产品的情况很少,然而,一些人报告说,他们使用应用程序听睡前故事。访谈允许更多的描述和关于在家中使用技术的育儿决策的细微差别。关于儿童使用数字技术的家庭规则并没有专门针对就寝时间或技术对睡眠质量、持续时间或时间的潜在影响。基于技术的睡眠辅助工具的使用可能会增加,并且需要更好地了解这些技术的潜在益处和成本。
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引用次数: 0
O015 Measuring Body Movements during Sleep. Sonomat Vs Video Polysomnography 015测量睡眠时的身体运动。声纳与视频多导睡眠图
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.015
M Lu, D Fitzgerald, C Sullivan, K Waters
Abstract Background Restless sleep is common in children, and video polysomnography (vPSG) has been used to score body movements during sleep. The Sonomat provides a contactless, portable alternative for home sleep studies over several nights. This study aimed to compare body movements measured by the Sonomat with those scored using vPSG. Methods Twenty-nine children (13 females, 16 males) with a median age of 5.4 years underwent concurrent Sonomat and vPSG studies. Movement indices per hour of sleep period and movement duration (%) were blindly scored on separate days. Statistical analysis included the Wilcoxon rank test and Pearson's correlations. Results Movement indices were higher on the Sonomat than vPSG (median 38.6/hr vs. 22.7/hr, p &lt; 0.001), but movement duration did not differ (median 10.8% vs. 10.5%, p = 0.092). Comparing movements above 5 seconds, the indices became more comparable (15.9/hr vs. 19.2/hr, p = 0.05). The correlation between devices was weak for movement indices (r = 0.37, p = 0.051) but strong for movement duration (r = 0.81, p &lt; 0.001). The Sonomat identified 82.5% of movements seen on vPSG, while vPSG identified only 43.6% of those on the Sonomat. Conclusion The Sonomat offers a contactless and portable alternative to vPSG for assessing body movements during sleep in children. It exhibited higher sensitivity in detecting shorter movements and was comparable to vPSG in movement duration. These findings suggest that the Sonomat holds promise for evaluating restless sleep in children.
儿童睡眠不安是很常见的,视频多导睡眠描记(vPSG)已被用于记录睡眠期间的身体运动。Sonomat为几个晚上的家庭睡眠研究提供了一种非接触式、便携的选择。这项研究旨在比较由索诺玛测量的身体运动和用vPSG评分的身体运动。方法29例儿童(女13例,男16例),中位年龄5.4岁,同时进行索诺玛和vPSG研究。每小时睡眠时间的运动指数和运动持续时间(%)分别在不同的天进行盲法评分。统计分析包括Wilcoxon秩检验和Pearson相关性。结果sononomat组的运动指数高于vPSG组(中位38.6/hr vs. 22.7/hr, p <0.001),但运动持续时间没有差异(中位数10.8% vs. 10.5%, p = 0.092)。对比5秒以上的运动,各项指标更具可比性(15.9/hr vs. 19.2/hr, p = 0.05)。器械与运动指标的相关性较弱(r = 0.37, p = 0.051),与运动持续时间的相关性较强(r = 0.81, p <0.001)。Sonomat识别出vPSG上82.5%的动作,而vPSG仅识别出Sonomat上43.6%的动作。结论:Sonomat为评估儿童睡眠时的身体运动提供了一种非接触式、便携的vPSG替代方案。它在检测较短的运动中表现出更高的灵敏度,在运动持续时间上与vPSG相当。这些发现表明,索诺马特有望评估儿童的不安性睡眠。
{"title":"O015 Measuring Body Movements during Sleep. Sonomat Vs Video Polysomnography","authors":"M Lu, D Fitzgerald, C Sullivan, K Waters","doi":"10.1093/sleepadvances/zpad035.015","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.015","url":null,"abstract":"Abstract Background Restless sleep is common in children, and video polysomnography (vPSG) has been used to score body movements during sleep. The Sonomat provides a contactless, portable alternative for home sleep studies over several nights. This study aimed to compare body movements measured by the Sonomat with those scored using vPSG. Methods Twenty-nine children (13 females, 16 males) with a median age of 5.4 years underwent concurrent Sonomat and vPSG studies. Movement indices per hour of sleep period and movement duration (%) were blindly scored on separate days. Statistical analysis included the Wilcoxon rank test and Pearson's correlations. Results Movement indices were higher on the Sonomat than vPSG (median 38.6/hr vs. 22.7/hr, p &amp;lt; 0.001), but movement duration did not differ (median 10.8% vs. 10.5%, p = 0.092). Comparing movements above 5 seconds, the indices became more comparable (15.9/hr vs. 19.2/hr, p = 0.05). The correlation between devices was weak for movement indices (r = 0.37, p = 0.051) but strong for movement duration (r = 0.81, p &amp;lt; 0.001). The Sonomat identified 82.5% of movements seen on vPSG, while vPSG identified only 43.6% of those on the Sonomat. Conclusion The Sonomat offers a contactless and portable alternative to vPSG for assessing body movements during sleep in children. It exhibited higher sensitivity in detecting shorter movements and was comparable to vPSG in movement duration. These findings suggest that the Sonomat holds promise for evaluating restless sleep in children.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"134 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
P063 Long-term Non-invasive Ventilation in Patients with COPD: A Retrospective Cohort Study. COPD患者长期无创通气:一项回顾性队列研究。
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.148
R Broadhead, S Mukherjee, V Aiyappan, C Chai-Coetzer, S Ullah, A Walker
Abstract Introduction Domiciliary long-term non-invasive ventilation (LT-NIV) is an accepted therapy for patients with severe chronic obstructive pulmonary disease (COPD) and chronic hypercapnia. This study aimed to characterise patients with COPD who were commenced on LT-NIV. Methods A retrospective analysis was performed of all patients prescribed LT-NIV with a primary physician-diagnosis of COPD, between June 2016 and March 2022 at an Australian tertiary hospital. Results 333 patients were commenced on LT-NIV, of whom 67 (20%) had COPD. Inpatient LT-NIV Initiation: 53/67 (79%) were commenced on LT-NIV during an inpatient admission with acute exacerbation of COPD. Patients were elderly (age, mean 69± SD 9.5 years), predominantly female (60%) with moderate-severe COPD (FEV1 37±18%) and mild-moderate comorbidity burden (Charlson Comorbidity Index Score 2.1±1.4). Prior to LT-NIV, 64% patients had a sleep study with 15% having severe OSA (AHI≥30 or ODI≥30). 30% previously required acute NIV. Pre-admission non-exacerbated PaCO2 was 58±7.3mmHg During admission, all inpatients demonstrated hypercapnia (PaCO2≥45mmHg). Peak inpatient PaCO2 was 87±20mmHg, with persistent hypercapnia on discharge 58±9.0mmHg. On discharge, IPAP and EPAP settings were 17±3.8 and 7.7cm±2.7cmH2O respectively. There was a non-significant reduction in respiratory-related and all-cause hospitalizations in the 12-months following LT-NIV initiation (p=0.66 and 0.53 respectively). Outpatient LT-NIV Initiation: [Further data collection in progress] Discussion This study illustrates the real-world prescription of LT-NIV for COPD at our centre, with the majority being initiated in the inpatient setting, rather than early outpatient reassessment. A prospective multi-centre analysis is required to better understand the nuances of LT-NIV prescription in patients with COPD.
居家长期无创通气(LT-NIV)是重度慢性阻塞性肺疾病(COPD)和慢性高碳酸血症患者公认的治疗方法。这项研究的目的是对开始接受LT-NIV治疗的COPD患者进行特征分析。方法回顾性分析2016年6月至2022年3月澳大利亚某三级医院所有经主治医生诊断为COPD的患者。结果333例患者开始接受LT-NIV治疗,其中67例(20%)患有COPD。住院患者LT-NIV开始:53/67(79%)患者在COPD急性加重住院期间开始使用LT-NIV。患者为老年人(平均69±SD 9.5岁),以女性为主(60%),伴中重度COPD (FEV1 37±18%)和轻中度合并症负担(Charlson共病指数评分2.1±1.4)。在LT-NIV之前,有64%的患者进行睡眠研究,其中15%的患者患有严重的OSA (AHI≥30或ODI≥30)。30%以前需要急性NIV。入院前无加重PaCO2为58±7.3mmHg,入院时所有住院患者均表现为高碳酸血症(PaCO2≥45mmHg)。住院患者PaCO2峰值为87±20mmHg,出院时持续高碳酸血症58±9.0mmHg。出院时,IPAP和EPAP设置分别为17±3.8和7.7cm±2.7cmH2O。在开始使用LT-NIV后的12个月内,呼吸相关和全因住院率无显著降低(p分别=0.66和0.53)。本研究说明了我们中心在现实世界中使用LT-NIV治疗慢性阻塞性肺病的情况,其中大多数是在住院时开始使用的,而不是早期门诊重新评估。需要一项前瞻性多中心分析来更好地了解慢性阻塞性肺病患者LT-NIV处方的细微差别。
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引用次数: 0
P031 A Novel Oral Appliance Implementation Protocol Using Nightly Portable Monitoring for OSA Patients Failing CPAP therapy CPAP治疗失败的OSA患者夜间便携式监测的新型口腔器械实施方案
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.116
I Ling, J Christoforou, G Chin, P Currie
Abstract Introduction Oral Appliance Therapy (OAT) is an effective second line treatment for OSA. However, OAT devices do not have active efficacy monitoring, hence little is known about methods to best identify the optimal degree of mandibular advancement. Methods Consecutive OSA patients undergoing OAT at a sleep disorders service were recruited to participate in a novel titration protocol using nightly monitoring via a portable device (NightOwl®, Ectosense, Belgium). Demographic & sleep study (PSG) data, and key NightOwl® metrics were collected. A treatment PSG was conducted at conclusion of OAT implementation using identified optimal point of mandibular advancement. Results 80 subjects were recruited (52 male, 65%) with mean (±SD) age 49±12 years, BMI 28±4.4 kg/m2, Epworth score (ESS) 9.1±4.9. Baseline PSG showed mean AHI 28±20 events/hr, nadir SpO2 84±21%, time SpO2&lt;90% 8.3±30 minutes. Blood pressure monitoring at baseline showed mean day BP 123/70mmHg and night BP 106/57mmHg. The mean mandibular advancement implemented was 2.9±1.7mm. Post treatment mean ESS was 5.1±3.5 (p&lt;0.001). 62/68 (91%) subjects reported perceived benefit on OAT, 49/53 (92%) reduced snoring, 51/62 (82%) improved sleep, 49/62 (79%) increased energy. Treatment PSG on completion of the protocol showed AHI 14±10 events/hr (p&lt;0.001), nadir SpO2 82±33% (p&gt;0.05), time SpO2&lt;90% 1.2±21 minutes (p=0.04). 48/63 (76%) met the AHI definition of OAT success. Discussion This study demonstrates a novel OAT protocol which led to minimal degree of mandibular advancement, resulting in high rates of symptom benefit and effective treatment of OSA.
口腔器械治疗(Oral Appliance Therapy, OAT)是OSA有效的二线治疗方法。然而,OAT装置没有主动的疗效监测,因此很少知道如何最好地确定下颌前进的最佳程度。方法招募在睡眠障碍服务中心接受OAT治疗的连续OSA患者,通过便携式设备(NightOwl®,Ectosense, Belgium)进行夜间监测,参与一项新的滴定方案。人口,收集睡眠研究(PSG)数据和关键的NightOwl®指标。在OAT实施结束时,使用确定的下颌前进最佳点进行治疗PSG。结果共纳入80例受试者,其中男性52例,占65%,平均(±SD)年龄49±12岁,BMI 28±4.4 kg/m2, Epworth评分(ESS) 9.1±4.9。基线PSG显示平均AHI 28±20事件/小时,最低点SpO2 84±21%,时间SpO2<90% 8.3±30分钟。基线血压监测显示日均血压123/70mmHg,夜间血压106/57mmHg。下颌平均前移2.9±1.7mm。治疗后平均ESS为5.1±3.5 (p<0.001)。62/68(91%)的受试者报告了OAT的益处,49/53(92%)减少了打鼾,51/62(82%)改善了睡眠,49/62(79%)增加了精力。方案完成时PSG显示AHI 14±10事件/小时(p=0.04),最低点SpO2 82±33% (p=0.04), SpO2<90%时间1.2±21分钟(p=0.04)。48/63(76%)符合AHI对OAT成功的定义。本研究展示了一种新的OAT方案,该方案可使下颌前移程度最小,从而导致高症状缓解率和OSA的有效治疗。
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引用次数: 0
P100 Acceptance, Compliance and Efficacy of Oral Appliance Therapy by Patients Suffering from Sleep Apnoea. 睡眠呼吸暂停患者口腔矫治器治疗的接受度、依从性及疗效。
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.185
N Rather, R Shankumar, A Nizamuddin, D Mansfield
Abstract Background Obstructive Sleep Apnoea (OSA) represents an established risk factor for several medical conditions. The evidence demonstrates that OSA can be effectively treated by an oral appliance. However, there less information about the role of an oral appliance in a clinical care model in terms of uptake and efficacy. This study aimed at examining the efficacy of an intervention in dental public health settings in Melbourne, Australia. Methods Data were collected from the 2018-2021. Participants who fitted inclusions criteria completed two instruments. The Epworth Sleepiness Score (ESS) was used to assess the Subjective daytime sleepiness, and the Apnoea Hypopnea Index (AHI) objectively evaluated the severity of OSA. Participants were further asked to self-report felt improvements post intervention. Paired t-tests were used to compare pre-test and the post-test results. Results 34 participants had complete before and after data recorded. The mean age of the final samples of 66.4 (s.d., 14.2), the majority were female (67.7%). Participants unanimously acknowledged improvements after the intervention. Findings also indicated that after the intervention, participants had significantly lower EES scores compared to their baseline scores (6.9 vs 12.7; p&lt;0.001). Regarding the AHI, at post-test, participants had significantly lower AHI scores compared to their baseline scores (13.8 vs. 19.2; p&lt;0.001). Conclusions Present results indicate the use of oral appliance will ultimately benefit public patients who suffer from OSA. After the intervention, there were both objective and subjective improvements in OSA. Thus, findings provide valuable inputs and guidance for the design and implementation for larger efficacy trial.
背景阻塞性睡眠呼吸暂停(OSA)是几种医学条件下的既定危险因素。有证据表明,使用口腔器械可以有效地治疗阻塞性睡眠呼吸暂停。然而,关于口腔矫治器在临床护理模式中的作用,在吸收和疗效方面的信息较少。本研究旨在检查干预在澳大利亚墨尔本牙科公共卫生设置的效果。方法收集2018-2021年的数据。符合纳入标准的参与者完成了两个工具。采用Epworth嗜睡评分(ESS)评价白天主观嗜睡,采用呼吸暂停低通气指数(AHI)客观评价OSA的严重程度。参与者进一步被要求自我报告干预后的感觉改善。配对t检验用于比较前测和后测结果。结果34例受试者完成了前后数据记录。最终样本的平均年龄为66.4岁(标准差14.2),以女性居多(67.7%)。参与者一致承认干预后情况有所改善。研究结果还表明,干预后,参与者的EES得分显著低于基线得分(6.9 vs 12.7;p&肝移植;0.001)。关于AHI,在测试后,参与者的AHI得分明显低于基线得分(13.8比19.2;p&肝移植;0.001)。结论使用口腔矫治器对阻塞性睡眠呼吸暂停(OSA)患者最终是有益的。干预后,OSA客观和主观均有改善。因此,研究结果为更大规模疗效试验的设计和实施提供了有价值的输入和指导。
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引用次数: 0
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