Maurits de Ruiter (MD, DDS) NVTS pre-conference course 4 april 2019 Slaap-registratie Maurits de Ruiter (MD, DDS) NVTS pre-conference course 4 april 2019

Polysomnografie 1. EEG - Electro-encephalography 2. ECG - Electro-cardiography 3. EOG - Electro-oculography 4. EMG - Electro-myography 5. Nasal and oral airflow 6. Pulse-oximetry 7. Body position minimum of 12 channels requiring 22 wire attachments

Richtlijn OSA (2018)

Richtlijn OSA (2018)

Peripheral Arterial Tonometry (PAT) 14 studies 909 patiens available for pooling Overall, correlation of the RDI and AHI was high (r = 0.889 [95% CI, 0.862-0.911]; P < .001). Studies comparing the RDI between PAT and PSG had a combined correlation of 0.879 (95% CI, 0.849-0.904; P < .001); those comparing the AHI, 0.893 (0.857-0.920; P < .001); and those comparing the ODI, 0.942 (0.894-0.969; P < .001). Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: meta-analysis." JAMA Otolaryngology–Head & Neck Surgery 139.12 (2013): 1343-1350.

The WatchPat (Itamar Medical, Ltd) Pulse oximetry Actigraphy Peripheral Arterial Tonometry (PAT) Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: meta-analysis." JAMA Otolaryngology–Head & Neck Surgery 139.12 (2013): 1343-1350.

Discussie Niet in: Patiënten met verdenking centraal slaapapneu Periodic limb movement disorder Moderate or severe pulmonary disease Neuromuscular disease Congestive heart failure Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: meta-analysis." JAMA Otolaryngology–Head & Neck Surgery 139.12 (2013): 1343-1350.

Discussie Wat kan PAT NIET? differentieren tussen de verschillende type van slaapapneu (central, obstructive, mixed) Advies van meeste studies is excluderen van patiënten met Diabetes Perifere neuropathy Vasculopathy Cardiovasculaire aandoeningen Gebruik van α-adrenergic receptor–blocking agents. Yalamanchali, Sreeya, et al. "Diagnosis of obstructive sleep apnea by peripheral arterial tonometry: meta-analysis." JAMA Otolaryngology–Head & Neck Surgery 139.12 (2013): 1343-1350.

DiagnOSAS - OSAsense Digitale vragenlijst Pulse oximeter Berlin Questionnaire STOP-BANG Athens insomnia scale Pulse oximeter

ECTOsense - NightOwl

Veel meer pulsoximeters…

ECTOsense - NightOwl

ECTOsense - NightOwl

Samenvattend PSG gouden standaard PG type 3 en PAT mogelijk voor diagnostiek, maar onder specifieke voorwaarden Onderscheid maken voor toepassing: Screening Diagnose Follow-up Nieuwe ontwikkelingen heel interessant!!

Hartelijk dank voor uw aandacht Maurits de Ruiter m.h.deruiter@amc.uva.nl