Esophageal pressure monitoring in detection of sleep-disordered breathing

Abstract

Objective: The aim was to study the value of esophageal pressure monitoring combined with limited polygraphic recording (oxygen saturation, respiratory and leg movements, airflow, body position, and snoring sound) in diagnosis of sleep-disordered breathing.

Study design: A prospective study of consecutive patients with snoring was carried out.

Methods: Sixty-seven patients underwent an overnight study on ward. Patients with normal oxygen desaturation index and any periodic breathing disturbances combined with elevated esophageal pressure were further studied with complete polysomnography.

Results: The patient compliance with esophageal catheter was 87%. Esophageal pressure monitoring increased effectively the detection of sleep-disordered breathing with limited polygraphic recording. Sixty-seven percent of the patients with normal oxygen desaturation index and respiratory-related esophageal pressure variation had sleep-disordered breathing on complete polysomnography. Increased esophageal pressure variation was significantly related with oxygen desaturation index and obstructive sleep apnea diagnosis (P <.001). All together, 48% of the mainly nonobese snorers had objective findings of sleep-disordered breathing. Patients with upper airway resistance syndrome were few. Fifteen percent of the patients had periodic leg movements. Neither subjective or objective sleepiness nor snoring or obesity adequately exposed sleep-disordered breathing in this material.

Conclusion: Esophageal pressure monitoring increases markedly the diagnostic value of limited polygraphic recording as a screening study for sleep-disordered breathing.