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Feb 2018 DOI 10.14302/issn.2329-9487.jhc-18-1932
The aim of this study was to assess the use of ambulatory acoustic cardiography during the initial data collection of the longitudinal study of a rural population in Switzerland (n=297, mean age 48.9 ±16.5 years, 57% female). Ambulatory acoustic cardiography non-invasively can assess sleep disordered breathing (SDB) and provides markers of left ventricular systolic and diastolic dysfunction. The percentage of the third heart sound detected during sleep decreased significantly across age groups (age < 40 years, 40-60 years, > 60 years) for both genders (males, p=0.04; females, p=0.02). The percentage of a fourth heart sound detected exhibited an increasing trend for both genders with age suggesting increased diastolic dysfunction with aging. Mean electromechanical activation time (EMAT) during sleep was within the normal range across age groups and both genders (male 93.7 ± 11.6 ms, female 94.6 ± 13.0 ms), and did not vary significantly with age. A large proportion of subjects had a high likelihood of sleep disordered breathing (17.6%). Baseline characteristics categorized by SDB severity indicate increasing age, male gender and being overweight (BMI ≥ 25) to be associated with greater SDB severity. Acoustic cardiography findings categorized by SDB severity reveal increased nocturnal non-dipping heart rate, presence of atrial fibrillation, prolonged QRS duration and QTc interval, increased percentage of fourth heart sound detected, and longer EMAT to be significantly associated with greater SDB severity. Overall, acoustic cardiography detected a very low prevalence of systolic dysfunction, age-related increases in diastolic dysfunction and a moderate prevalence of sleep disordered breathing.
Mar 2016 DOI 10.14302/issn.2379-8572.joa-15-891
Background: Despite its expense, labor and intrusiveness, polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea (OSA). Recently, commercially available electronic activity monitors, such as Fitbit, have become widely accepted and can provide an estimate of sleep patterns for screening children with possible OSA. A previous study demonstrated Fitbit to be valid compared to PSG in adults. To date, these devices have not been extensively utilized for research in children with sleep disordered breathing (SDB). Objective: To evaluate the validity of the Fitbit activity monitor compared to PSG in children and adolescents with SDB. Methods: Data was collected from 14 children, ages 3 through 11, who were scheduled for a PSG during the study period. Fitbit was worn concurrently during the night of the PSG. Analyses were performed by comparing total sleep time, number of awakenings, sleep efficiency and wake after sleep onset (WASO) Fitbit parameters with the corresponding parameters measured by PSG using Spearman’s rho. Fitbit movement epochs were also compared to PSG epochs showing movement behavior. Results: Pilot data suggest that Fitbit demonstrates a high sensitivity for sleep, a low specificity for wake and a trend suggesting good association of movement measurements. Conclusion: Although Fitbit is not as accurate as PSG for determining wakefulness, it may be a useful screening device to assess gross sleep quality in children. Further studies are indicated to validate these findings.
Oct 2014 DOI 10.14302/issn.2329-9487.jhc-14-edt3
An overview of blood pressure regulation in hypoxia addresses altitude physiology, sleep disordered breathing, and cardiopulmonary disease. It reviews pathophysiology and therapeutic implications.