Reliability of scoring respiratory disturbance indices and sleep staging.
Coralyn Whitney,Daniel J. Gottlieb,Susan Redline,Robert G. Norman,Russell Dodge,Eyal Shahar,Susan Surovec,F. Javier Nieto +7 more
TLDR
The SHHS achieved a high degree of intrascorer and interscorer reliability for the scoring of sleep stage and RDI in unattended in-home PSG studies.Abstract:
Study Objectives: Unattended, home-based polysomnography (PSG) is increasingly used in both research and clinical settings as an alternative to traditional laboratory-based studies, although the reliability of the scoring of these studies has not been described The purpose of this study is to describe the reliability of the PSG scoring in the Sleep Heart Health Study (SHHS), a multicenter study of the relation between sleep-disordered breathing measured by unattended, in-home PSG using a portable sleep monitor, and cardiovascular outcomes Design: The reliability of SHHS scorers was evaluated based on 20 randomly selected studies per scorer, assessing both interscorer and intrascorer reliability Results: Both inter- and intrascorer comparisons on epoch-by-epoch sleep staging showed excellent reliability (kappa statistics >080), with stage 1 having the greatest discrepancies in scoring and stage 3/4 being the most reliably discriminated The arousal index (number of arousals per hour of sleep) was moderately reliable, with an intraclass correlation (ICC) of 054 The scorers were highly reliable on various respiratory disturbance indices (RDls), which incorporate an associated oxygen desaturation in the definition of respiratory events (2% to 5%) with or without the additional use of associated EEG arousal in the definition of respiratory events (ICC>090) When RDI was defined without considering oxygen desaturation or arousals to define respiratory events, the RDI was moderately reliable (ICC=074) The additional use of associated EEG arousals, but not oxygen desaturation, in defining respiratory events did little to increase the reliability of the RDI measure (ICC=077) Conclusions: The SHHS achieved a high degree of intrascorer and interscorer reliability for the scoring of sleep stage and RDI in unattended in-home PSG studiesread more
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Rules for Scoring Respiratory Events in Sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events
Richard B. Berry,Rohit Budhiraja,Daniel J. Gottlieb,David Gozal,Conrad Iber,Vishesh K. Kapur,Carole L. Marcus,Reena Mehra,Sairam Parthasarathy,Stuart F. Quan,Susan Redline,Kingman P. Strohl,Sally L. Davidson Ward,Michelle M. Tangredi +13 more
TL;DR: The task force made recommendations concerning recommended and alternative sensors for the detection of apnea and hypopnea to be used during diagnostic and positive airway pressure (PAP) titration polysomnography, and recommended scoring rules.
Journal ArticleDOI
Association of Sleep-Disordered Breathing, Sleep Apnea, and Hypertension in a Large Community-Based Study
F. Javier Nieto,Terry Young,Bonnie K. Lind,Eyal Shahar,Jonathan M. Samet,Susan Redline,Ralph B. D'Agostino,Anne B. Newman,Michael D. Lebowitz,Thomas G. Pickering +9 more
TL;DR: The findings from the largest cross-sectional study to date indicate that SDB is associated with systemic hypertension in middle-aged and older individuals of different sexes and ethnic backgrounds.
Journal ArticleDOI
Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study.
Eyal Shahar,Coralyn Whitney,Susan Redline,Lee Et,A.B. Newman,F. J. Nieto,George T. O'Connor,Lori L. Boland,Joseph E. Schwartz,Jonathan M. Samet +9 more
TL;DR: Findings are compatible with modest to moderate effects of sleep-disordered breathing on heterogeneous manifestations of CVD within a range of AHI values that are considered normal or only mildly elevated.
Journal ArticleDOI
Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: The sleep heart health study
Daniel J. Gottlieb,Gayane Yenokyan,Anne B. Newman,George T. O'Connor,Naresh M. Punjabi,Stuart F. Quan,Stuart F. Quan,Susan Redline,Helaine E. Resnick,Elisa K. Tong,Marie Diener-West,Eyal Shahar +11 more
TL;DR: Obstructive sleep apnea is associated with an increased risk of incident heart failure in community-dwelling middle-aged and older men; its association with incident coronary heart disease in this sample is equivocal.
Journal ArticleDOI
Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study.
Terry Young,Eyal Shahar,F. Javier Nieto,Susan Redline,Anne B. Newman,Daniel J. Gottlieb,Joyce A. Walsleben,Laurel Finn,Paul L. Enright,Jonathan M. Samet +9 more
TL;DR: A significant proportion of occult SDB in the general population would be missed if screening or case finding were based solely on increased body habitus or male sex, particularly in older adults.