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Lu M, Penzel T, Thomas RJ. Cardiopulmonary Coupling. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1384:185-204. [PMID: 36217085 DOI: 10.1007/978-3-031-06413-5_11] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cardiopulmonary coupling (CPC) is a technique that generates sleep spectrogram by calculating the cross-spectral power and coherence of heart rate variability and respiratory tidal volume fluctuations. There are several forms of CPC in the sleep spectrogram, which may provide information about normal sleep physiology and pathological sleep states. Since CPC can be calculated from any signal recording containing heart rate and respiration information, such as photoplethysmography (PPG) or blood pressure, it can be widely used in various applications, including wearables and non-contact devices. When derived from PPG, an automatic apnea-hypopnea index can be calculated from CPC-oximetry as PPG can be obtained from oximetry alone. CPC-based sleep profiling reveals the effects of stable and unstable sleep on sleep apnea, insomnia, cardiovascular regulation, and metabolic disorders. Here, we introduce, with examples, the current knowledge and understanding of the CPC technique, especially the physiological basis, analytical methods, and its clinical applications.
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Affiliation(s)
- Mi Lu
- Department of Otolaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
- Interdisciplinary Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Thomas Penzel
- Interdisciplinary Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Robert J Thomas
- Division of Pulmonary and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Xie X, Song J, Zhu J, Han M, He Y, Huang J, Tao J, Wu J. The effectiveness of Tai Chi on the depressive symptom of young adults with subthreshold depression: a study protocol for a randomized controlled trial. Trials 2021; 22:106. [PMID: 33516240 PMCID: PMC7847042 DOI: 10.1186/s13063-021-05054-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 01/20/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Depression is seriously affecting the physical and mental health of young people worldwide. Subthreshold depression, as an early stage of depression, is essential for early prevention and treatment of depression. Tai Chi, as a traditional Chinese mind-body therapy, may become an alternative intervention. However, the neurophysiological mechanism of Tai Chi for young people with subthreshold depression remains unclear, restricting its further promotion and application. Therefore, rigorous randomized clinical trials are needed to further observe the intervention effect of Tai Chi on young adults with subthreshold depression and explore the neurophysiological mechanism. METHOD/DESIGN This report describes a two-arm, randomized, parallel controlled trial with allocation concealment and assessor blinding. A total of 64 eligible participants are randomly allocated to the Tai Chi group and the waiting list group in a 1:1 ratio. Participants in the Tai Chi group receive 12 weeks of Tai Chi training, with a total of 36 times and each for 60 min. Specifically, the participants in the waiting list group are requested to maintain their routine lifestyle. In this study, the primary outcome measure is the mean change in scores on the PHQ-9 and HAMD-17 between baseline and 12 weeks; the secondary outcomes are the mean change in the scores on CES-D, CPSS, GAD-7, and PSQI. Besides, the saliva cortisol levels and fMRI are monitored to explore the mechanism of action of Tai Chi on subthreshold depression. DISCUSSION The protocol uses a randomized controlled trial to examine the effectiveness of Tai Chi for young adults with subthreshold depression and explore neurophysiological mechanisms. If the test results are positive, it can be verified that Tai Chi can promote the physical and mental health of young adults with subthreshold depression. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900028289 . Registered on 17 December 2019.
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Affiliation(s)
- Xiaoting Xie
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China
| | - Jian Song
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China.,Fujian Collaborative Innovation Center for Rehabilitation Technology, Fuzhou, 350122, China
| | - Jingfang Zhu
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China.,Fujian Collaborative Innovation Center for Rehabilitation Technology, Fuzhou, 350122, China
| | - Mengyu Han
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China
| | - Youze He
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China
| | - Jia Huang
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China.,Fujian Collaborative Innovation Center for Rehabilitation Technology, Fuzhou, 350122, China.,TCM Rehabilitation Research Center Of SATCM, Fuzhou, 350122, China
| | - Jing Tao
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China.,Fujian Collaborative Innovation Center for Rehabilitation Technology, Fuzhou, 350122, China.,TCM Rehabilitation Research Center Of SATCM, Fuzhou, 350122, China
| | - Jingsong Wu
- Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China. .,Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fu Jian university of TCM), Ministry of Education, Fuzhou, 350122, China. .,Fujian Collaborative Innovation Center for Rehabilitation Technology, Fuzhou, 350122, China. .,TCM Rehabilitation Research Center Of SATCM, Fuzhou, 350122, China.
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Xu A, Zimmerman CS, Lazar SW, Ma Y, Kerr CE, Yeung A. Distinct Insular Functional Connectivity Changes Related to Mood and Fatigue Improvements in Major Depressive Disorder Following Tai Chi Training: A Pilot Study. Front Integr Neurosci 2020; 14:25. [PMID: 32581734 PMCID: PMC7295154 DOI: 10.3389/fnint.2020.00025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 04/15/2020] [Indexed: 11/29/2022] Open
Abstract
Objective: Tai chi (TC), a contemplative practice combining slow movements and deep breathing, has been shown to be clinically effective in alleviating depressive symptoms. Feelings of fatigue or low vitality often accompany major depressive disorder (MDD) though they are commonly overlooked and not well understood neurologically. By using resting state functional connectivity (rs-FC) using the insula as the seed, this study examines the relationship between mood and vitality symptoms in MDD and how they are impacted by TC training. Methods: Patients (N = 16) with MDD participated in a 10-week TC intervention. Self-report scores of vitality (using the SF-36 scale) and depressed mood (using the Beck Depression Inventory) as well as rs-fMRI were collected pre- and post-intervention. A seed-to-voxel approach was used to test whether changes in insular rs-FC were related to therapeutic improvement in MDD-related symptoms resulting from TC practice. Results: We found decreased self-reported depressed mood and increased vitality following the TC intervention. Furthermore, decreases in depressed mood were associated with increased rs-FC between the right anterior insula (AIC) and superior temporal gyrus and caudate (cluster-corrected p < 0.05). Increased vitality was associated with increased rs-FC between the right posterior insula (PIC) and regions associated with sensorimotor processes (cluster-corrected p < 0.05). Conclusion: These results provide support for differential changes in insula connectivity as neural correlates of symptom improvement in MDD.
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Affiliation(s)
- Anna Xu
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, United States
| | - Chloe S Zimmerman
- Department of Neuroscience, Brown University, Providence, RI, United States.,Alpert Medical School, Brown University, Providence, RI, United States
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Yan Ma
- Harvard Medical School, Boston, MA, United States.,Center for Dynamical Biomarkers, Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Catherine E Kerr
- Alpert Medical School, Brown University, Providence, RI, United States
| | - Albert Yeung
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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The effect of eurhythmy therapy on self-determination, health complaints and psychological symptoms: A non-randomised trial. Complement Ther Med 2020; 49:102347. [PMID: 32147084 DOI: 10.1016/j.ctim.2020.102347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 11/06/2019] [Accepted: 02/12/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To study healthcare quality improvement through Eurhythmy Therapy (EYT) relative to treatment as usual without EYT. DESIGN Pre/post-follow-up analysis with a comparison group. SETTING Patients of 13 eurhythmy therapists and people with similar physical or psychological health complaints. Respondents' mean age was 60 years (SD = 13.83). INTERVENTION EYT-sessions for the complaint versus treatment as usual. OUTCOME MEASURES Self-determination (BPNSFS); health complaint (1 item); sleeping problems (SCL-90); psychological symptoms and work/study dysfunction (SQ-48) at pre-measure (t0), post-measure (t1) and one-month follow-up (t2). RESULTS A small positive effect of EYT on self-determination (eta2 = .08) and a medium negative effect of EYT on health complaints at t1 and t2 (η2p = .24 and .22). The effect of EYT was n.s. on sleeping problems, n.s. on psychological symptoms and medium negative n.s. on work/study dysfunction, the last within a small sample size (n < 30; eta2 = .13). CONCLUSIONS EYT-participants (n = 38) improved more on self-determination, health complaints and probably also on work/study dysfunction than the comparison group (n = 42), but not on sleeping problems and psychological symptoms. Results should be treated with caution, because the comparison group is not comparable to the EYT-group in the motivation to engage in EYT and the sample size was small.
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Ma Y, Sun S, Zhang M, Guo D, Liu AR, Wei Y, Peng CK. Electrocardiogram-based sleep analysis for sleep apnea screening and diagnosis. Sleep Breath 2020; 24:231-240. [PMID: 31222591 PMCID: PMC6925360 DOI: 10.1007/s11325-019-01874-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 05/18/2019] [Accepted: 05/24/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE Despite the increasing number of research studies of cardiopulmonary coupling (CPC) analysis, an electrocardiogram-based technique, the use of CPC in underserved population remains underexplored. This study aimed to first evaluate the reliability of CPC analysis for the detection of obstructive sleep apnea (OSA) by comparing with polysomnography (PSG)-derived sleep outcomes. METHODS Two hundred five PSG data (149 males, age 46.8 ± 12.8 years) were used for the evaluation of CPC regarding the detection of OSA. Automated CPC analyses were based on ECG signals only. Respiratory event index (REI) derived from CPC and apnea-hypopnea index (AHI) derived from PSG were compared for agreement tests. RESULTS CPC-REI positively correlated with PSG-AHI (r = 0.851, p < 0.001). After adjusting for age and gender, CPC-REI and PSG-AHI were still significantly correlated (r = 0.840, p < 0.001). The overall results of sensitivity and specificity of CPC-REI were good. CONCLUSION Compared with the gold standard PSG, CPC approach yielded acceptable results among OSA patients. ECG recording can be used for the screening or diagnosis of OSA in the general population.
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Affiliation(s)
- Yan Ma
- Center for Dynamical Biomarkers, Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
| | - Shuchen Sun
- Department of Otolaryngology and South Campus Sleep Center, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Ming Zhang
- Nanjing Integrated Traditional Chinese and Western Medicine Hospital, Nanjing, 210000, China
| | - Dan Guo
- Center for Dynamical Biomarkers, Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Arron Runzhou Liu
- Center for Dynamical Biomarkers, Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Yulin Wei
- China-Japan Friendship Hospital, Beijing, 100029, China
| | - Chung-Kang Peng
- Center for Dynamical Biomarkers, Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
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Cardiopulmonary coupling analysis predicts early treatment response in depressed patients: A pilot study. Psychiatry Res 2019; 276:6-11. [PMID: 30981097 DOI: 10.1016/j.psychres.2019.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 03/30/2019] [Accepted: 04/01/2019] [Indexed: 11/23/2022]
Abstract
This pilot study evaluated the effect of anti-depression treatment on sleep quality and symptoms of depression in patients with major depressive disorder, and identified cardiopulmonary coupling (CPC) indices for predicting early response. Forty-one Han Chinese patients with major depressive disorder were assessed for objective sleep quality before treatment (baseline) and at 2 weeks using CPC. Subjective sleep quality and depression levels were measured at baseline and 2 and 4 weeks after treatment, using the 24-item Hamilton Rating Scale for Depression (HAMD-24), Epworth Sleepiness Scale (ESS), and Pittsburgh Sleep Quality Index (PSQI). Objective and subjective sleep quality, and depression symptoms, improved after treatment. Significant correlations were found between CPC variables at baseline and depression symptom improvement after 2 weeks of treatment. Total sleep time at baseline significantly correlated with somnipathy score reduction at week 2. Total in-bed time at week 2 significantly correlated with reductions in anxiety/somatic symptoms and retardation score, and total HAMD-24 score at week 4. In binary logistic regression, the total in-bed time at baseline was significantly associated with treatment response. Our findings suggest that objective sleep quality measured by CPC analysis is useful for predicting treatment response to antidepressant treatment in patients with major depressive disorder.
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Complexity-Based Measures of Heart Rate Dynamics in Older Adults Following Long- and Short-Term Tai Chi Training: Cross-sectional and Randomized Trial Studies. Sci Rep 2019; 9:7500. [PMID: 31097732 PMCID: PMC6522618 DOI: 10.1038/s41598-019-43602-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/27/2019] [Indexed: 12/19/2022] Open
Abstract
Measures characterizing the complexity of heart rate (HR) dynamics have been informative in predicting age- and disease-related decline in cardiovascular health, but few studies have evaluated whether mind-body exercise can impact HR complexity. This study evaluated the effects of long-term Tai Chi (TC) practice on the complexity of HR dynamics using an observational comparison of TC experts and age- and gender-matched TC-naïve individuals. Shorter-term effects of TC were assessed by randomly assigning TC-naïve participants to either TC group to receive six months of TC training or to a waitlist control group. 23 TC experts (age = 63.3 ± 8.0 y; 24.6 ± 12.0 y TC experience) and 52 TC-naïve (age = 64.3 ± 7.7 y) were enrolled. In cross-sectional analyses, TC experts had a higher overall complexity index (CI, p = 0.004) and higher entropy at multiple individual time scales (p < 0.05); these findings persisted in models accounting for age, gender, body mass index (BMI), and physical activity levels. Longitudinal changes in complexity index did not differ significantly following random assignment to six months of TC vs. a waitlist control; however, within the TC group, complexity at select time scales showed statistically non-significant trends toward increases. Our study supports that longer-term TC mind-body training may be associated with increased complexity of HR dynamics.
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Sarabzadeh M, Azari BB, Helalizadeh M. The effect of six weeks of Tai Chi Chuan training on the motor skills of children with Autism Spectrum Disorder. J Bodyw Mov Ther 2019; 23:284-290. [PMID: 31103109 DOI: 10.1016/j.jbmt.2019.01.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 01/23/2019] [Accepted: 01/23/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Autism Spectrum Disorder (ASD) is related to a dysfunction of central nervous system that most frequently appears at the age of three years old. There is no certain cure for this disorder; however, decreasing complications can produce positive life changes. Increasing physical activity is an appealing method for reducing behavioral disorders in ASD. Since Tai Chi Chuan training improves focus, attention to internal cues and balance, it seems to be an effective system for autistic children. MATERIALS & METHODS 18 children with ASD in the age range between 6-12 years old were divided randomly into experimental and control groups. The experimental group participated in a six-week program of Tai Chi Chuan consisting of 18 sessions, limited to 60 min each. To assess motor skills, an M-ABC test was used during pre- and post-assessment. In order to analyze the data, dependent and independent T tests were used (with significance level of 0.05). RESULTS Results showed a significant difference in the subscales of ball skills and balance performance (P < 0.05) and no significant difference in the manual agility scale (P > 0.05) between the two groups. CONCLUSION According to the results, it may be concluded that forms of Tai Chi Chuan improve balance and motion coordination. Moreover, this training consists of slow motion workouts with strongly focused attention, which may lead to developed control of body motions with harmony and discipline. Therefore, Tai Chi Chuan training seems to be a helpful therapeutic program to reduce motor limitations, and these benefits can be transferred to daily life in autistic children.
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Affiliation(s)
- Mostafa Sarabzadeh
- Department of Physiotherapy, Science and Research Branch, Aja University of Medical Sciences, Tehran, Iran.
| | - Bita Bordbar Azari
- Founder and Chief of the Body Balance Committee, Sport for All Federation, Tehran, Iran.
| | - Masoumeh Helalizadeh
- Department of Exercise Physiology, Sport Medicine Research Center, Sport Sciences Research Institute, Tehran, Iran.
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Ma Y, Yang AC, Duan Y, Dong M, Yeung AS. Quality and readability of online information resources on insomnia. Front Med 2017; 11:423-431. [PMID: 28500432 DOI: 10.1007/s11684-017-0524-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 01/24/2017] [Indexed: 10/19/2022]
Abstract
The internet is a major source for health information. An increasing number of people, including patients with insomnia, search for remedies online; however, little is known about the quality of such information. This study aimed to evaluate the quality and readability of insomnia-related online information. Google was used as the search engine, and the top websites on insomnia that met the inclusion criteria were evaluated for quality and readability. The analyzed websites belonged to nonprofit, commercial, or academic organizations and institutions such as hospitals and universities. Insomnia-related websites typically included definitions (85%), causes and risk factors (100%), symptoms (95%), and treatment options (90%). Cognitive behavioral therapy for insomnia (CBT-I) was the most commonly recommended approach for insomnia treatment, and sleep drugs are frequently mentioned. The overall quality of the websites on insomnia is moderate, but all the content exceeded the recommended reading ease levels. Concerns that must be addressed to increase the quality and trustworthiness of online health information include sharing metadata, such as authorship, time of creation and last update, and conflicts of interest; providing evidence for reliability; and increasing the readability for a layman audience.
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Affiliation(s)
- Yan Ma
- Division of Interdisciplinary Medicine and Biotechnology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.
| | - Albert C Yang
- Division of Interdisciplinary Medicine and Biotechnology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Ying Duan
- Sleep Medicine Center, Airforce General Hospital, Beijing, 100142, China
| | - Ming Dong
- IBM, Software Development Lab, Littleton, MA, 01460, USA
| | - Albert S Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
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Li Y, Gao H, Ma Y. Evaluation of pulse oximeter derived photoplethysmographic signals for obstructive sleep apnea diagnosis. Medicine (Baltimore) 2017; 96:e6755. [PMID: 28471970 PMCID: PMC5419916 DOI: 10.1097/md.0000000000006755] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 03/31/2017] [Accepted: 04/06/2017] [Indexed: 12/18/2022] Open
Abstract
High prevalence of obstructive sleep apnea (OSA) has increased the demands for more convenient and accessible diagnostic devices other than standard in-lab polysomnography (PSG). Despite the increasing utility of photoplethysmograph (PPG), it remains understudied in underserved populations. This study aimed to evaluate the reliability of a standard pulse oximeter system with an automated analysis based on the PPG signal for the diagnosis of OSA, as compared with PSG derived measures.Consecutive out-patients with suspect OSA completed a PPG monitoring simultaneous with an overnight in-lab standard PSG. Forty-nine OSA patients (38 males, age 43.5 ± 16.9 years, BMI 26.9 ± 0.5 kg/m) were included in this study. Automated analyses were based on PPG and oximetry signals only. The PPG calculated measures were compared with PSG derived measures for agreement tests.Respiratory events index derived from PPG significantly correlated with PSG-derived apnea-hypopnea index (r = 0.935, P < .001). The calculation of total sleep time and oxygen desaturation index from PPG and PSG also significantly correlated (r = 0.418, P = .003; r = 0.933, P < .001, respectively). Bland-Altman plots showed good agreement between the PPG and the PSG measures. The overall sensitivity and specificity of PPG are good, especially in moderate and severe OSA groups.The tested PPG approach yielded acceptable results compared to the gold standard PSG among moderate to severe OSA patients. A pulse oximeter system with PPG recording can be used for the diagnosis or screening of OSA in high risk population.
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Affiliation(s)
- Yan Li
- Aerospace Sleep Medicine Center, Airforce General Hospital of PLA, Beijing, China
| | - He Gao
- Aerospace Sleep Medicine Center, Airforce General Hospital of PLA, Beijing, China
| | - Yan Ma
- Aerospace Sleep Medicine Center, Airforce General Hospital of PLA, Beijing, China
- Division of Interdisciplinary Medicine and Biotechnology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Tseng PH, Lee PL, Hsu WC, Ma Y, Lee YC, Chiu HM, Ho YL, Chen MF, Wu MS, Peng CK. A Higher Proportion of Metabolic Syndrome in Chinese Subjects with Sleep-Disordered Breathing: A Case-Control Study Based on Electrocardiogram-Derived Sleep Analysis. PLoS One 2017; 12:e0169394. [PMID: 28081171 PMCID: PMC5231382 DOI: 10.1371/journal.pone.0169394] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 12/16/2016] [Indexed: 12/11/2022] Open
Abstract
Objective The prevalence of metabolic syndrome (MS) has increased rapidly in Taiwan and worldwide. We aim to determine the association between sleep-disordered breathing (SDB) and MS in a Chinese general population. Methods This case-control study recruited subjects who have undergone a prospective electrocardiogram-based cardiopulmonary coupling (CPC) sleep spectrogram as part of the periodic health check-ups at the National Taiwan University Hospital. Comprehensive anthropometrics, blood biochemistry, prevalence of MS and its individual components were compared with Bonferroni correction between 40 subjects with SDB, defined as the CPC-derived apnea–hypopnea index (CPC-AHI) >5 event/hour and 80 age- and sex-matched controls, defined as CPC-AHI <1 event/hour. MS was diagnosed based on the Adult Treatment Panel III, with a modification of waist circumference for Asians. Results Subjects with SDB were more obese with larger waist circumferences (95.1±12.9 vs. 87.3±6.9, P < .001) and borderline higher BMI (27.0±4.9 vs. 24.3±2.5, P = .002). Waist circumference was independently associated with the presence of SDB after adjustment for BMI, systolic blood pressure and fasting blood glucose in multiple regression analyses. Subjects with SDB had a higher prevalence of central obesity (72.5% vs. 42.5%, P = .002), hyperglycemia (45.0% vs. 26.3%, P = .04), MS (45.0% vs. 22.5%, P = .01) and number of MS components (2.4 ± 1.6 vs. 1.7 ± 1.4, P = .01) than the control group. Waist circumference was significantly correlated with both CPC-AHI (r = .492, P = .0013) and PSG-AHI (r = .699, P < .0001) in the SDB group. Conclusions SDB was associated with a higher prevalence of MS and its individual components, notably central obesity, in a Chinese general population. Large-scale screening of high risk population with MS to identify subjects with SDB for appropriate management is warranted.
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Affiliation(s)
- Ping-Huei Tseng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Lin Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Chung Hsu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yan Ma
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Yi-Chia Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Lwun Ho
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Fong Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail:
| | - Chung-Kang Peng
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
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