Assessment of respiratory effort during sleep: Esophageal pressure versus noninvasive monitoring techniques

作者：Vandenbussche Nele L^*; Overeem Sebastiaan; van Dijk Johannes P; Simons Pieter Jan; Pevernagie Dirk A

来源：Sleep Medicine Reviews, 2015, 24: 28-36.

DOI：10.1016/j.smrv.2014.12.006

• Respiratory effort
• Assessment
• Sleep apnea
• Esophageal pressure
• Pulse transit time
• Mandibular movement
• Inductance plethysmography
• Electromyography
• Venous pressure

Monitoring of respiratory effort is paramount in the clinical diagnostic recording of sleep. Increased respiratory effort is a sign of obstructive sleep-disordered breathing and is associated with arousals from sleep. Respiration is the result of muscle activity that induces negative intrathoracic pressure and expansion of the thoracic and abdominal cavities. Therefore respiratory effort may be recorded from mechanical, electrical and electromechanical signals. Several techniques are available for the recording of respiratory effort. Monitoring of esophageal pressure is still the method of choice, as the pressure signal directly reflects the respiratory muscle force. However, esophageal pressure monitoring is cumbersome and may be replaced with noninvasive techniques. In order to be reliable, these techniques must be validated against the esophageal pressure standard. The present review presents a concise description of the technical principles and, if available, a comparison with esophageal pressure data, based on a systematic literature search. Most data are available on respiratory inductance plethysmography, and confirm that this technique is suitable for routine diagnostic investigation of respiratory effort during sleep. Pulse transit time, diaphragmatic electromyography, snoring loudness, suprastemal pressure monitoring, midsagittal jaw movement and forehead venous pressure monitoring are promising alternative techniques although only limited validation is available.

• 出版日期2015-12