Multifunctional Monitoring: is it Possible to Simultaneously Evaluate Blood Pressure and Sleep‐Disordered Breathing?

Objective Carry out a comparative assessment of respiratory performance, based on multifunctional monitoring (MFM) and the recommended practice for complete polysomnography (PSG), and evaluate the effect of the blood pressure (BP) measurements in MFM on the quality of sleep.
Materials and Methods At the first stage, 22 healthy volunteers (control group) underwent concomitant PSG and MFM, and 14 patients with suspected sleep-disordered breathing (SDB) underwent only PSG. At the second stage, concomitant PSG and MFM were performed in patients with confirmed SDB.
Results In the control group, MFM detected a lower level of SpO2, a lower desaturation index (DI), and a higher apnea index (AI) than in the PSG group. However, the apnea-hypopnea index (AHI) was comparable in both groups. During concomitant PSG-MFM, the measurements of BP increased the number of micro-arousals only in the SDB group.
Conclusion Results of the assessment of respiratory performance in MFM are comparable in both groups. The detected features of MFM indicators in the evaluation of the chest movements using rheopneumography, criteria different from that generally used for desaturation and hypoxemia, can lead to underestimation of desaturation and DI and underestimation of AI in the control group. The measurements of BP during sleep induced micro-arousals in the SDB group.

1. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal. 2018;39(33):3021–104. DOI: 10.1093/eurheartj/ehy339

2. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased Prevalence of Sleep-Disordered Breathing in Adults. American Journal of Epidemiology. 2013;177(9):1006–14. DOI: 10.1093/aje/kws342

3. Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. The Lancet Respiratory Medicine. 2015;3(4):310–8. DOI: 10.1016/S2213-2600(15)00043-0

4. Bochkarev M.V., Korostovtseva L.S., Filchenko I.A., Rotar O.P., Svir‐ jaev Yu.V., Zhernakova Yu.V. et al. Complaints on sleep breathing disorder and cardiovascular risk factors in Russian regions: data from ES‐SE‐RF study. Russian Journal of Cardiology. 2018;6:152–8. [Russian] DOI: 10.15829/1560-4071-2018-6-152-158

5. American Sleep Disorders Association. Practice parameters for the use of portable recording in the assessment of obstructive sleep apnea. Standards of Practice Committee of the American Sleep Disorders Association. Sleep. 1994;17(4):372–7. PMID: 7973322

6. Collop NA, Anderson WM, Boehlecke B, Claman D, Goldberg R, Gottlieb DJ et al. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine. 2007;3(7):737–47. PMID: 18198809

7. Tikhonenko V.M., Aparina I.V. Possibilities of Holter monitoring in assessing the relationship between cardiac rhythm disturbances and cardiac conduction with apnea episodes. Journal of Arrhythmology. 2009;55:49–55. [Russian]

8. Lenz MCS, Martinez D. Awakenings change results of nighttime ambulatory blood pressure monitoring: Blood Pressure Monitoring. 2007;12(1):9–15. DOI: 10.1097/MBP.0b013e3280858c70

9. American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events. The 2007 AASM Scoring Manual vs. the AASM Scoring Manual v2.0. 2012. [Av at: https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/11/Summary-of-Updates-in-v2.0-FINAL.pdf]

10. Nonin. Nonin Pulse Oximeters and Sensors manuals. . [Av. at: https://www.nonin.com/products/?fwp_product_types=sensors]

11. Ohayon M, Wickwire EM, Hirshkowitz M, Albert SM, Avidan A, Daly FJ et al. National Sleep Foundation’s sleep quality recommendations: first report. Sleep Health. 2017;3(1):6–19. DOI: 10.1016/j.sleh.2016.11.006

12. Lederbogen F, Schredl M, Weber-Hamann B, Kniest A, Heuser I, Deuschle M. Effect of ambulatory blood pressure measurement on sleep in patients with a major depressive episode. Blood Pressure Monitoring. 2003;8(5):187–90. DOI: 10.1097/01.mbp.0000097241.01232.57