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Type: Journal article
Title: Increased thoracoabdominal asynchrony during breathing periods free of discretely scored obstructive events in children with upper airway obstruction
Author: Immanuel, S.
Kohler, M.
Martin, A.
Kennedy, J.
Pamula, Y.
Kabir, M.
Saint, D.
Baumert, M.
Citation: Sleep and Breathing: international journal of the science and practice of sleep medicine, 2015; 19(1):65-71
Publisher: Springer Berlin Heidelberg
Issue Date: 2015
ISSN: 1520-9512
Statement of
Sarah A. Immanuel, Mark Kohler, James Martin, Declan Kennedy, Yvonne Pamula, Muammar M. Kabir, David A. Saint, Mathias Baumert
Abstract: Objective This study aims to investigate the impact of upper airway obstruction (UAO) in children by measuring thoracoabdominal asynchrony (TAA) during periods of sleep apnea/hypopnea and during scored-event-free (SEF) breathing periods. Methods Respiratory inductive plethysmographic signals were extracted from polysomnographic data, recorded before and after adenotonsillectomy in 40 children with UAO and 40 healthy, matched children at equivalent time points. Thoracoabdominal asynchrony was computed using a Hilbert transform-based phase difference estimation method in SEF periods during stage 2, stage 4 non-rapid eye movement (NREM), and rapid eye movement (REM) sleep and compared between the groups. Results At baseline, in the UAO group, TAA during obstructions were significantly higher than TAA during SEF periods in both stage 2 and REM sleep. Compared to controls, children with UAO had a significantly higher TAA during SEF periods in stage 2, stage 4 sleep, and REM sleep. This between-group difference was not significant post adenotonsillectomy. UAO group showed a significant decrease in TAA compared to their baseline during SEF stage 2 and 4 NREM, but not in REM. Conclusion Upper airway obstruction in children is associated with increased TAA during SEF periods, indicative of continuous partial obstruction of the upper airway. Adenotonsillectomy decreased this effect significantly in non-REM sleep as evidenced by reduced asynchrony levels post-surgery. TAA assessment during sleep may therefore provide additional diagnostic information.
Keywords: Thoracoabdominal asynchrony; Upper airway obstruction; Children; Sleep; Respiratory inductive plethysmography
Rights: © Springer-Verlag Berlin Heidelberg 2014
DOI: 10.1007/s11325-014-0963-3
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Electrical and Electronic Engineering publications

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