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Pulse Wave Photo-plethysmogram analysis, calculation and distribution of a reactivity index over 1837 polysomnographics recordings

vendredi 22 juin 2012, par Didier Cugy

Pulse Wave photoplethysmography uses light absorbance technology to detect waves produced by heart pulsation. This technique associated with absoprtion spectrophotometry is at origin of SpO2 measure. Photoplethysmogram is frequently a part of signals recorded during polysomnography. For Brosh and al this signal can be considered as good indicator of coronary pathology. For Kirichenko and al normalization of the pulse photoplethysmogram amplitude can be used as indicator of anti-hypertensive efficiency.
Clinical observation allows easy individualization of the photoplethysmography signal amplitude in touch with events arising during sleep. We attempted to develop an algorithm to analyse amplitude variations of pulse photoplethysmogram , we apply it to the database of our polysomnography recordings dantabase and analyse distribution according to sleep parameters parameters and subjective scales (Epworth, ADA PICHOT, Q2DA Pichot).
Material and Methods : Amplitude variations of the photopléthysmogram are calculated from a baseline elabored on slippery average of signal amplitude and filtered. Amplitude variations superior to 50 % of basic line are deducted and associated with the current period. This allow to calculate an index of reactivity of pulse wave (Pulse Wave Reactivity:PWR). This algorithm was applied to our database of 1837 polysomnography recordings made between 2002 and 2011. Results were visually validated.
Results : Average of PWR index reported to the total sleep time is 53/h±29/h. There are significant differences of index reported to sleep stage (SS : 54/h±33/h, SW : 44/h±32/h, REM : 67/h±35/h ; p < 0.001), sex (p < 0.001), age (p < 0.001). There is significant correlations (p < 0.05) between the index and Epworth Sleepiness Score (ESS), Pichot asthenia scale (ADA) and Pichot depression scale (Q2DA).
Conclusion : Because of relations between Pulse Wave Eeactivity and others sleep elements it seems necessary to introduce this new parameter in polygraphy and polysomnography analysis.
An analysis of the reference distribution in normal population must be made.

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