PSG Öncesi Horlama Sesi Analiz Parametreleri Obstrüktif Uyku Apne Sendromunun Şiddetini Öngörmede Kullanılabilir mi?

Öz

Amaç: Horlama semptomu, OSAS hastalarının ana semptomlarından biridir. Bu çalışmada, horlama sesi analizi ile OSAS evreleri arasındaki ilişkinin araştırılması amaçlandı. Metod: Tüm hastalara tüm gece polisomnografi (PSG) testi uygulandı. Horlama sesi parametreleri, PRAAT akustik analiz yazılımı kullanılarak ölçüldü. Bu parametreler ile OSAS şiddeti ve horlama sesi özellikleri ile OSAS alt tipleri arasındaki ilişkiler prospektif olarak analiz edildi. Bulgular: Çalışmaya OSAS tanısı almış yetmiş yedi hasta dahil edildi. Shimmer (ses dalgalanması) skorlarının hafif OSAS’tan şiddetli OSAS’a doğru anlamlı şekilde azaldığı bulundu (p = 0.045). Ortalama pitch (perde) skorları hafiften şiddetliye doğru artmasına rağmen, bu fark istatistiksel olarak anlamlı bulunmadı (p = 0.16). Ancak alt grup analizinde, ortalama perde skorunun şiddetli grupta, hafif ve orta şiddetteki gruplara göre anlamlı derecede yüksek olduğu görüldü (p = 0.022). REM-dominant OSAS hastalarında shimmer skorları, REM-dominant olmayanlara göre anlamlı derecede daha yüksekti (p = 0.006). Ayrıca, shimmer skorları obez hastalarda obez olmayanlara göre ve 40 yaş üzeri hastalarda 40 yaş altındakilere göre anlamlı derecede daha yüksekti (sırasıyla p = 0.032; p < 0.01). ROC analizi ile şiddetli OSAS sınıflandırmasını öngörmede ortalama perde için ≥74.65 Hz eşik değeri belirlendi (AUC = 0.69; p = 0.017). Sonuç: Sonuçlarımız, horlama sesinin akustik ses analizi gibi hızlı ve noninvaziv bir yöntemle analiz edilmesinin, özellikle ivedi olarak tanı konması gereken ileri evre OSAS olgularının PSG öncesi taramasında kolaylıkla uygulanabileceğini göstermesi açısından önemlidir.

Anahtar Kelimeler

• Obstrüktif uyku apnesi sendromu
• horlama
• ses analizi
• schimmer değeri
• pitch değeri

Etik Beyan

Çalışma, Ekim 2020 ile Mart 2021 tarihleri ​​arasında Tokat Gaziosmanpaşa Üniversitesi Tıp Fakültesi Uyku Bozuklukları Anabilim Dalı'na başvuran OSAS'lı hastalarda prospektif olarak planlandı. Çalışma öncesinde Tokat Gaziosmanpaşa Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu'ndan (protokol no: 19-KAEK-178, 24.09.2019) yerel etik kurul onayı alındı. PSG testinden önce tüm olgulardan yazılı onam alındı. Bu çalışmada takip edilen raporlama kılavuzu SPIRIT çalışma protokolleridir. Çalışma Helsinki Bildirgesi'nde belirtilen kurallara göre yürütüldü ve tamamlandı.

Could Snoring Sound Analysis Parameters Be Used To Predict The Severity Of Obstructive Sleep Apnea Syndrome Before PSG?

Öz

Background/aim: Snoring is one of the main symptoms of obstructive sleep apnea syndrome (OSAS) patients. In this study, it was aimed to investigate the relationship between snoring sound analysis and OSAS stages. Materials and Methods: All patients underwent full-night PSG test. Sound parameters were measured using the PRAAT acoustic analysis program. The relationship between these parameters and degree of OSAS, and also the relationship between snoring sound and types of OSAS were analyzed prospectively. Results: Seventy seven patients diagnosed OSAS were included the study. It was found that the shimmer scores decreased significantly from mild OSAS to severe OSAS (p=0.045). Although mean pitch scores increased from mild to severe OSAS, it was not found to be statistically significant (p=0.16). Mean pitch score was found to be significantly higher in the severe group compare to mild and moderate group in subgroup analysis (p=0.022). Shimmer scores were found significantly higher in REM-predominant OSAS patients than without REM-predominant OSAS patients (p=0.006). Shimmer scores were significantly higher in obese patients than in non-obese patients and in patients over 40 years of age years than under 40 years of age (p=0.032; p<0.01; respectively). The ROC analysis was performed to determine the cutoff value of mean Pitch (≥74.65) in predicting severe OSAS classification (AUC=0.69; p=0.017). Conclusion: Our results are important to show that, analysis of snoring sound with a noninvasive method of acoustic voice analysis, can be applied quickly and easily in the pre-PSG screening in especially clinically important advanced-stage OSAS cases that should be diagnosed urgently.

Anahtar Kelimeler

• Obstructive sleep apnea syndrome
• snoring
• sound analysis
• schimmer value
• pitch value

Etik Beyan

The study was planned prospectively in OSAS patients who were referred to Tokat Gaziosmanpasa University, Faculty of Medicine, Department of Sleep Disorders between October 2020 and March 2021. Local ethics committee approval was obtained from the clinical research ethics committee of the Tokat Gaziosmanpasa University, Faculty of Medicine, (protocol no: 19-KAEK-178, 24.09.2019) prior to the study. Written informed consent was obtained from all subjects before PSG test. The reporting guideline that has been followed in this study is SPIRIT study protocols. The study was conducted and completed according to the rules outlined in the Declaration of Helsinki.

Kaynakça

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