ECG-derived estimators of sleep physiology

基于心电图的睡眠生理学估计器

• 批准号: 6854808
• 负责人: Robert Joseph Thomas
• 金额: $ 16.6万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-05 至 2007-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6854808
• 关键词: REM sleep; adult human (21+); bioimaging /biomedical imaging; biomarker; biomedical automation; child (0-11); data collection methodology /evaluation; diagnosis design /evaluation; diagnosis quality /standard; electrocardiography; human data; neuropsychology; patient /disease registry; physiologic stressor; polysomnography; respiratory airflow disorder; respiratory disorder diagnosis; sleep apnea; sleep disorders; statistics /biometry

DESCRIPTION (PROVIDED BY APPLICANT): Polysomnograms are labor-intensive, expensive and impractical to perform repeatedly to assess therapeutic efficacy. Typical measures of sleep disordered breathing (SDB) severity include event counts, such as the apnea-hypopnea index, that utilize physiologically arbitrary scoring criteria. These measures correlate only modestly with neurobehavioral and cardiovascular outcomes in adults and children. Standard sleep stage scoring differentiates REM and NREM sleep types and NREM depth, but provides little information about physiological stability. Thus, there is a need for a simple, inexpensive and easily repeatable measure of the presence and impact of SDB on sleep state physiology and stability. The investigators have developed a fully automated surface electrocardiogram (ECG)-derived sleep physiology estimator, based on the quantitative analysis of cardiopulmonary coupling from a single-lead ECG. This approach combines the use of mechanical and autonomic effects of physiologic vs. periodic breathing on ECG parameters related to heart rate variability and QRS electrical axis. Physiologically unstable sleep associated with SDB manifests the EEG morphology of cyclic alternating pattern (CAP), regardless of conventional stage scoring. In contrast, periods of non-CAP represent physiologically stable sleep behavior. We have found that the coupling estimator shows a strong correlation with CAP and non- CAP states, thus providing a promising new biomarker of sleep physiology and pathology based on the percentage of sleep spent in periods of unstable sleep behavior. The goals of the proposed research are to: 1) Refine the technique using a sleep laboratory database. 2) Test it, using established databases, as a SDE detector in community-dwelling adults (Sleep Heart Health Study, SHHS) and children (Neurobehavioral Assessment and Pediatric Sleep, NAPS). 3) To correlate the biomarker with excessive daytime sleepiness, subjective sleep quality and cardiovascular morbidity (SHHS), and reduced neurocognitive function (NAPS).

描述（由申请人提供）：多次劳动术是劳动密集型，昂贵且不切实际的，可以反复进行评估治疗功效。睡眠障碍呼吸（SDB）严重程度的典型度量包括事件计数，例如呼吸暂停指数，利用生理上任意的评分标准。这些措施仅与成人和儿童的神经行为和心血管结局相关。标准睡眠阶段评分与REM和NREM睡眠类型和NREM深度区分，但几乎没有有关生理稳定性的信息。因此，需要对SDB对睡眠状态生理和稳定性的存在和影响进行简单，廉价且易于重复的衡量。研究人员基于对单铅ECG的心肺耦合的定量分析，开发了全自动的表面心电图（ECG）衍生的睡眠生理估计器。这种方法结合了生理和周期性呼吸对与心率变异性和QRS电轴相关的ECG参数的机械和自主性效应的使用。与SDB相关的生理上不稳定的睡眠表现出环状交流模式（CAP）的脑电图形态，无论传统阶段评分如何。相比之下，非CAP时期代表生理上稳定的睡眠行为。我们发现，耦合估计量与CAP和非CAP状态显示出很强的相关性，因此基于在不稳定的睡眠行为时期花费的睡眠百分比，提供了有希望的新型睡眠生理和病理生物标志物。拟议研究的目标是：1）使用睡眠实验室数据库完善技术。 2）使用已建立的数据库作为社区居民（睡眠心脏健康研究，SHHS）和儿童（神经行为评估和儿科睡眠，午睡）中的SDE检测器进行测试。 3）将生物标志物与白天过度嗜睡，主观睡眠质量和心血管发病率（SHHS）以及降低神经认知功能（NAPS）相关联。