中国耳鼻咽喉头颈外科2025，Vol.32Issue(5)：316-322,7.DOI:10.16066/j.1672-7002.2025.05.009
用于辅助阻塞性睡眠呼吸暂停低通气综合征患者下颌前移矫治器滴定的远程无感智能睡眠监测系统的构建与评价
The construction and evaluation of a remotely contactless intelligent sleep monitoring system for the mandibular advance device titration of obstructive sleep apnea hypopnea syndrome
摘要
Abstract
OBJECTIVE To construct a remotely contactless intelligent sleep monitoring system(RCISMS),which could be used to assist the titration of Mandibular advancement device(MAD)for the patients of obstructive sleep apnea-hypopnea syndrome(OSAHS),and to verify the effectiveness of the system.METHODS RCISMS was constructed by multidisciplinary medical-engineering cooperation of clinical medicine,biosensing technology,and artificial intelligence;And the diagnostic and therapeutic efficacy evaluation of RCISMS was improved through clinical comparative tests.From December 2023 to May 2024,A total of 176 patients who would receive polysomnography(PSG)evaluation were prospectively collected in the Department of Otolaryngology,Beijing Jishuitan Hospital,Capital Medical University.All the patients met the inclusion criteria and underwent synchronized sleep monitoring using RCISMS and PSG.Through repeatedly comparison with the'gold standard'PSG,the intelligent algorithm of Apnea-hypopnea index(AHI)which is the diagnosis and efficacy of OSAHS was improved in RCISMS.The consistency and correlation of the results between RCISMS and PSG were statistically analyzed.RESULTS RCISMS can continuously monitor the patient's natural sleep in a remote,non-direct contact way,and can upload data in real time,analyze and diagnose intelligently,and the results can be distributed to the doctor and the patient simultaneously.Among the parameters monitored by RCISMS,the AHI,lowest peripheral oxygen saturation(LSpO2),mean peripheral oxygen saturation(MSpO₂),sleep efficiency,and the proportion of light sleep stage showed strong correlation with the corresponding PSG parameters(all P<0.05).The LSpO2 and the proportion of light sleep stage showed no statistically significant differences between the two monitoring methods.The consistency test between RCISMS and PSG for AHI classification yielded a Kappa value of 0.627(P<0.001),indicating moderate agreement.The efficacy evaluation of RCISMS for MAD treatment assessment demonstrated 73.8%sensitivity and 100%specificity for OSAHS detection,which helped to precisely identify patients who had achieved full recovery at the endpoint of MAD titration.RCISMS demonstrated sensitivities of 73.8%,84.8%,and 92.7%for detecting mild,moderate,and severe OSAHS respectively,with corresponding specificities of 78.4%,91.6%,and 95.9%.This system can objectively reflect therapeutic changes during MAD titration.CONCLUSION This study established the RCISMS,which provided a novel titration procedure for the MAD titration of OSAHS patients,and might potentially overcome existing limitations in current clinical MAD titration procedures.关键词
睡眠呼吸暂停,阻塞性/多导睡眠监测/非接触式监测/下颌前移矫治器Key words
Sleep Apnea,Obstructive/polysomnography/contactless monitoring/mandibular advancement device引用本文复制引用
雷蕙嘉,朱思翔,葛晓竹,来佑青..用于辅助阻塞性睡眠呼吸暂停低通气综合征患者下颌前移矫治器滴定的远程无感智能睡眠监测系统的构建与评价[J].中国耳鼻咽喉头颈外科,2025,32(5):316-322,7.基金项目
北京市医院管理中心临床医学发展专项经费(YGLX202316) （YGLX202316）
