0
Clinical Investigations: SLEEP AND BREATHING |

Accuracy of Respiratory Inductive Plethysmography for the Diagnosis of Upper Airway Resistance Syndrome*

Daniel I. Loube, MD, FCCP; Teotimo Andrada, MS; Robin S. Howard, MA
Author and Funding Information

*From the Sleep Disorders Center, Pulmonary and Critical Care Medicine Service, Walter Reed Army Medical Center, Washington, DC.

Correspondence to: Daniel I. Loube, MD, FCCP, Director, Sleep Disorders Center, Walter Reed Army Medical Center, Washington, DC 20307-5001; e-mail: MAJOR_DANIEL_LOUBE@WRAMC1-amedd.army.mil



Chest. 1999;115(5):1333-1337. doi:10.1378/chest.115.5.1333
Text Size: A A A
Published online

Objective: To determine the sensitivity and specificity of quantitative respiratory inductive plethysmography (RIP) compared with the “gold standard,” nocturnal esophageal pressure (Pes) measurement, in the diagnosis of upper airway resistance syndrome (UARS) in adults.

Methods: Fourteen consecutive patients without obstructive sleep apnea and suspected of having UARS underwent simultaneous measurement of Pes with a catheter and standard nocturnal polysomnography along with RIP. UARS events (RERAs, respiratory effort-related arousals) were identified by observing crescendo changes in Pes with a Pes nadir ≤ −12 cm H2O, followed by an arousal or microarousal. UARS was defined as ≥ 10 RERAs per hour. For each patient, the ratio of peak inspiratory flow to mean inspiratory flow (PIFMF) measured by RIP was performed during quiet wakefulness and with 40 randomly selected breaths in the supine position for two conditions: stage 2 sleep, immediately prior to arousals in any sleep stage. The mean PIFMF (wake-sleep) was calculated for each condition.

Results: The sensitivities and specificities, respectively, of RIP to distinguish UARS patients from non-UARS patients are from stage 2 sleep (67%, 80%), immediately prior to arousals (100%, 100%). For breaths occurring immediately prior to arousals, the mean PIFMF (wake-sleep) is ≥ 0.13 for UARS patients and < 0.13 for non-UARS patients.

Conclusion: The PIFMF measured by RIP allows for the most accurate identification of UARS patients when breaths are selected for analysis immediately prior to arousals.

Abbreviations: AHI = apnea-hypopnea index; BMI = body mass index; NPSG = nocturnal polysomnography; OSA = obstructive sleep apnea; Pes = esophageal pressure; PIFMF = peak inspiratory flow to mean flow ratio; RERA = respiratory effort-related arousal; RIP = respiratory inductive plethysmography; UARS = upper airway resistance syndrome

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
The Symptoms and Signs of Upper Airway Resistance Syndrome*: A Link to the Functional Somatic Syndromes
Adult Obstructive Sleep Apnea*: Pathophysiology and Diagnosis
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543