Watchpat 200

Watch pat 200 簡易型ポリソムノグラフィ

1企業ホームページより引⽤

2成⼈の睡眠時無呼吸症候群診断と治療のためのガイドラインより引⽤

⿐マスク式持続陽圧呼吸（NCPAP：nasal continuous positive airway pressure）⼝蓋垂軟⼝蓋咽頭形成術（UPPP：uvulopalatopharyngoplasty）⼝腔内装置（OA：oral appliance）

NCPAPの保険適応はPSGでAHI≧20，または簡易検査でAHI≧40

3

Abstract

Polysomnography is currently considered as the gold standard for the diagnosis of obstructive sleep apnea syndrome (OSAS). But high expense and the backlog of the sleep centers have resulted in a search for an alternative method of diagnosis.

The aim of this study is to assess the efficacy and reliability of Watch PAT as an alternate option in OSAS diagnosis.

The patients have worn a Watch PAT® 200 device in the sleep laboratory during a standard polysomnography. The correlation in REM and Non-REM AHI scores, sleep periods and the mean O2 saturation percentage between Watch PAT and PSG sleep studies were assessed.

There was a statistically significant very strong correlation between PSG and Watch PAT AHI scores (Spearman’s rho = 0.802 p < 0.001). The mean recording time with PSG and Watch PAT was 463.06 ± 37.08 and 469.33 ± 72.81 min, respectively, and there was no statistically significant difference (p = 0.068). However, there was a statistically significant difference between two methods regarding the average sleep time and REM sleep period. No statistically significant difference was revealed in the mean O2 saturation percentage (p < 0.001).

Watch PAT is an efficient device and is considered to be an adjunctive diagnostic method for PSG in diagnosis of OSAS.

The efficacy of Watch PAT in obstructive sleep apnea syndrome diagnosis.Körkuyu E, Düzlü M, Karamert R, Tutar H, Yılmaz M, Çiftçi B, Güven SF. Eur Arch Otorhinolaryngol. 2015 Jan;272(1):111-6.

The efficacy of Watch PAT in obstructive sleep apnea syndrome diagnosis.Körkuyu E, Düzlü M, Karamert R, Tutar H, Yılmaz M, Çiftçi B, Güven SF. Eur Arch Otorhinolaryngol. 2015 Jan;272(1):111-6.

概要 OSAS診断における簡易型ポリソムノグラフィのWatch pat 200の有効性と信頼性の評価．

Patients OSAS 30例（男性83.3%） BMI 29.6(4.4).

ExposureComparisonOutcome

同⼀患者に通常のポリソムノグラフィとWatch pat 200を同時につけて睡眠時間，REM/NonREM，AHI，SpO2などを測定．

Results AHIは有意に強い相関（r=0.802, p <0.001）．記録時間に差はないが，睡眠時間とREM睡眠の時間に測定に有意な差あり．（PSGとWatch patで結果が異なる）平均SpO2は差なし．

要するに Watch patの結果のAHIは信頼できるが，睡眠Stageは当てにならない

4

5

PSGのAHIと，WatchpadのAHIは相関が強く（r=0.802, p <0.001），系統誤差はなさそう．

Otorhinolaryngol. 2015 Jan;272(1):111-6.

それぞれの個体毎の差がどれくらいなのかは，分かりません．

ぎりぎり

Figure1 Watch padの写真（割愛）

6

Quick Diagnosis in Obstructive Sleep Apnea Syndrome: WatchPAT-200.Ceylan T, Fırat H, Kuran G, Ardıç S, Bilgin E, Celenk F.Iran Red Crescent Med J. 2012 Aug;14(8):475-8.

Background: Obstructive sleep apnea syndrome (OSAS) is a highly prevelant disorder and found in approximately 2-4% of middle-aged adults.

Objectives: To assess the efficacy of WatchPAT-200 in the diagnosis of obstructive sleep apnea syndrome (OSAS).

Patients and Methods: Patients suspected of having OSAS underwent overnight Level I polisomnography and simultaneously wore WatchPAT-200 in the sleep laboratory.

Results: 51 adult patients included in the study. The average age was 45.3±10.5 years and the average body mass index (BMI) was 29.4±4.0 kg/m2. There was a high agreement between PSG and Watch PAT regarding apnea-hypopnea index, respiratory disturbance index and oxygen desaturation index. Significant but a low agreement was found in stage 1 and 2 of non-REM sleep when two methods compared. No agreement was found between PSG and WatchPAT regarding stage 3 and 4 of non-REM sleep. Very low agreement was found between PSG and WatchPAT regarding the REM sleep.

Conclusions: WatchPAT-200 is an effective method in the diagnosis of OSAS.

Quick Diagnosis in Obstructive Sleep Apnea Syndrome: WatchPAT-200.Ceylan T, Fırat H, Kuran G, Ardıç S, Bilgin E, Celenk F.Iran Red Crescent Med J. 2012 Aug;14(8):475-8.

概要簡易型ポリソムノグラフィのWatch pat 200の有効性と信頼性の評価

Patients いびきや⽇中の眠気があるOSAS疑い 51例ExposureComparisonOutcome

同じ⼈にポリソムノグラフィとWatch pat 200を同時につけてAHI，RDI，ODI，睡眠Stageなどを評価．

Results AHI（ICC 0.941），respiratory disturbance index（ICC 0.916），oxygen desaturation index（ICC 0.877）で⼀致．睡眠Stage1・2では有意だが⼩さな⼀致（ICC 0.495）．睡眠Stage3・4では⼀致せず．REM睡眠では⾮常に低い⼀致（ICC 0.237）．

（ICCは級内相関係数で，0.7以上で関連が強いと判定することが多い）

要するに Watch patはAHIは評価できても睡眠Stage評価は信頼できない．

7

8

Study Objectives: To determine the relationships between key variables obtained from ambulatory polysomnography (PSG) and the wrist-worn Watch-PAT 200 device in pregnant women.

Methods: In this prospective cohort study, women in their third trimester of pregnancy underwent full overnight home PSG using the 22-channel MediPalm system and the Watch-PAT 200 device. PSGs were scored by a blinded, experienced technologist using AASM 2007 criteria; the Watch-PAT was scored automatically by the manufacturer’s proprietary software.

Results: A total of 31 pregnant women were studied. Mean age was 30.2 ± 7.1 years; mean gestational age was 33.4 ± 3.0 weeks; mean BMI was 31.9 ± 8.1 kg/m2; 39% of women were nulliparous. Key variables generated by PSG and Watch- PAT correlated well over a wide range, including the apneahypopnea index (AHI, r = 0.76, p < 0.001); respiratory disturbance index (RDI, r = 0.68, p < 0.001), mean oxygen saturation (r = 0.94, p < 0.001), and minimum oxygen saturation (r = 0.88, p < 0.001). The area under the curve for AHI ≥ 5 and RDI ≥ 10 were 0.96 and 0.94, respectively. Association between stage 3 sleep on PSG and deep sleep on Watch-PAT was poor. Watch- PAT tended to overscore RDI, particularly as severity increased.

Conclusions: Among pregnant women, Watch-PAT demonstrates excellent sensitivity and specifi city for identifi cation of obstructive sleep apnea, defi ned as AHI ≥ 5 on full PSG. Watch-PAT may overestimate RDI somewhat, especially at high RDI values

Validation of Watch-PAT-200 against polysomnography during pregnancy.O'Brien LM, Bullough AS, Shelgikar AV, Chames MC, Armitage R, Chervin RD. J Clin Sleep Med. 2012 Jun 15;8(3):287-94.

Validation of Watch-PAT-200 against polysomnography during pregnancy.O'Brien LM, Bullough AS, Shelgikar AV, Chames MC, Armitage R, Chervin RD. J Clin Sleep Med. 2012 Jun 15;8(3):287-94.

臨床的意義簡易型ポリソムノグラフィのWatch pat 200の有効性と信頼性の評価

Patients 妊婦 31例

ExposureComparisonOutcome

同じ⼈にPSGとWatch pat200を同時につけAHI，RDI，SpO2，睡眠Stageなどを⽐較

結果 PSGとはAHIは相関（r=0.76），respiratory disturbance index（r=0.69），平均SpO2（r=0.94）, 最低SpO2（r=0.88）.PSGのStage3と，Watch patのdeep sleepの関連は悪い.watch patでrespiratory disturbance indexは過⼤評価される傾向がある.

要するに WatchpatはAHIの値は⽐較的信⽤できる（とくに⽇常的にいびきがある場合）．睡眠Stageはかなり精度が悪い．

9

10

J Clin Sleep Med. 2012 Jun 15;8(3):287-94.

妊娠後期の若い⼥性

ウィルコクソンの符号順位検定で差がありますが，それぞれの個体毎の差がどれくらいなのかは，分かりません．Plotを⾒てみましょう

いびきのあるなしで層別化されています．いびきがある場合のAHIなどの相関は良好です 11


睡眠Stageは相関がないのが⼀⽬瞭然

12


AHI，RDIと⽐べ，睡眠Stageはてんでばらばら（精度が低い）RDIが⾼いときにWatchpadは過⼤評価することあり

相関の検定• 曲線関係や，特殊な直線は散布図を⾒ないと分からない

• 外れ値の影響を強く受ける

14


psgと⽐べ，WatchpadのAHI 4.9で感度88％特異度86％，RDI 9.3で感度100％，特異度82％

これまでのパルスオキシメトリーでは，AHI≧15で3%ODI ≧15は感度51％，特異度90％（Am Rev Respir Dis. 1993 Jan;147(1):50-3. ）

Watch pat 200

15

• 脳波は測らず，安価で簡便．• AHIは信⽤できるので外来でのスクリーニングやフォローアップに使いやすい．

• OSAS・CSASの判別の精度を調べた論⽂はない．• 睡眠Stageの結果は当てにならない

CSASの除外や睡眠の質はFull PSGを．

Watchpat 200

Health & Medicine

Transcript of Watchpat 200