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How are Pulse Change events determined?
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01-30-2022, 02:52 PM
RE: How are Pulse Change events determined?
Selfcoacher, can you point us in the direction of the literature? At some point we are planning on revising the pulse oximetry handling, so it would be good to have reference to point to.
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01-30-2022, 03:39 PM
RE: How are Pulse Change events determined?
(01-29-2022, 07:22 PM)StuartC Wrote: Thanks for the reply. I had more-or-less reached that conclusion. On one of the graphs there are flow limits and movements. On the other one leaks. All potential causes of arousals. It is difficult to get the timing precise though as syncing the wellue and the cpap is not easy. You should shoot for less than 10 arousals/pulse rises per hour, no matter the cause. You should not count the drops in heart rate and you should not count awake times.
01-31-2022, 05:47 PM
RE: How are Pulse Change events determined?
I agree that heart rate increases are more significant than decreases. The current numbers reported by OSCAR are still useful though and I see a high correlation between my PLMI (calculated from direct measurements of leg movements) and the OSCAR reported pulse change rate. There are some instances where OSCAR sees 2 drop events following an increase, and others where OSCAR doesn't report a drop event (due to the decrease being slower) but I would expect that the current reported value is close enough to double the value you would get by just counting increases.
This paper "Relationship between Arousal Intensity and Heart Rate Response to Arousal" (https://dx.doi.org/10.5665%2Fsleep.3560) finds that there is significant correlation between level of arousal and the heart rate increase level. And "The Sleep Apnea–Specific Pulse-Rate Response Predicts Cardiovascular Morbidity and Mortality" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483223/) concludes "Individuals with OSA who demonstrate an elevated ΔHR are at increased risk of cardiovascular morbidity and mortality. This study identifies a prognostic biomarker for OSA that appears useful for risk stratification..."
02-06-2022, 04:50 AM
RE: How are Pulse Change events determined?
Hi kappa, thanks for the interesting links. Nice find and good reading.
If I understand the findings in the 2nd of your references (Azarbarzin, Scott and others) this researches the Delta HR in response to OSA events, not just the Delta HR over the course of the whole night? If so, a good reason to reduce one's OSA count! Good to know!
02-06-2022, 07:30 PM
RE: How are Pulse Change events determined?
Hi SevereApnea, that study was looking for heart rate changes in a time window around apnea and hypopnea events and did not consider rapid heart rate changes outside of this. So yes, reducing OSA is a good thing. I still think there's value in looking at pulse change events for the entire night - one might have sleep arousals due other factors such as PLM.
Here's another paper: "Autonomic Arousals as Surrogates for Cortical Arousals Caused by Respiratory Events: A Methodological Optimization Study in the Diagnosis of Sleep Breathing Disorders" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927566/) that looks at heart rate acceleration (HRa) as a proxy for EEG arousal measurement. |
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