Slaapregistratie Maurits de Ruiter MD DDS NVTS preconference

Slaap-registratie Maurits de Ruiter (MD, DDS) NVTS pre-conference course 4 april 2019

Polysomnografie • • 1. EEG - Electro-encephalography 2. ECG - Electro-cardiography 3. EOG - Electro-oculography 4. EMG - Electro-myography 5. Nasal and oral airflow 6. Pulse-oximetry 7. Body position • minimum of 12 channels requiring 22 wire attachments

Richtlijn OSA (2018)

Richtlijn OSA (2018)

Peripheral Arterial Tonometry (PAT) • 14 studies • 909 patiens available for pooling • Overall, correlation of the RDI and AHI was high (r = 0. 889 [95% CI, 0. 862 -0. 911]; P <. 001). • Studies comparing the RDI between PAT and PSG had a combined correlation of 0. 879 (95% CI, 0. 849 -0. 904; P <. 001); • those comparing the AHI, 0. 893 (0. 857 -0. 920; P <. 001); and those comparing the ODI, 0. 942 (0. 894 -0. 969; P <. 001). Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: metaanalysis. " JAMA Otolaryngology–Head & Neck Surgery 139. 12 (2013): 1343 -1350.

The Watch. Pat (Itamar Medical, Ltd) • Pulse oximetry • Actigraphy • Peripheral Arterial Tonometry (PAT) Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: metaanalysis. " JAMA Otolaryngology–Head & Neck Surgery 139. 12 (2013): 1343 -1350.

Discussie • Niet in: • • • Patiënten met verdenking centraal slaapapneu Periodic limb movement disorder Moderate or severe pulmonary disease Neuromuscular disease Congestive heart failure Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: metaanalysis. " JAMA Otolaryngology–Head & Neck Surgery 139. 12 (2013): 1343 -1350.

Discussie • Wat kan PAT NIET? • differentieren tussen de verschillende type van slaapapneu (central, obstructive, mixed) • Advies van meeste studies is excluderen van patiënten met • • • Diabetes Perifere neuropathy Vasculopathy Cardiovasculaire aandoeningen Gebruik van α-adrenergic receptor–blocking agents. Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: metaanalysis. " JAMA Otolaryngology–Head & Neck Surgery 139. 12 (2013): 1343 -1350.

Diagn. OSAS - OSAsense • Digitale vragenlijst • Berlin Questionnaire • STOP-BANG • Athens insomnia scale • Pulse oximeter

ECTOsense - Night. Owl

Veel meer pulsoximeters…

ECTOsense - Night. Owl

ECTOsense - Night. Owl

Samenvattend • PSG gouden standaard • PG type 3 en PAT mogelijk voor diagnostiek, maar onder specifieke voorwaarden • Onderscheid maken voor toepassing: • Screening • Diagnose • Follow-up • Nieuwe ontwikkelingen heel interessant!!

Hartelijk dank voor uw aandacht Maurits de Ruiter m. h. deruiter@amc. uva. nl