arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2019-25-6-604-612arthyper-1779Research ArticleСТРАНИЦА СОМНОЛОГАSOMNOLOGIST’S PAGEПолисомнография или кардиореспираторное мониторирование – что выбрать для оптимальной диагностики нарушений дыхания во сне?Polysomnography or cardiorespiratory monitoring: what is the best method to diagnose sleep-disordered breathing?https://orcid.org/0000-0002-4982-628XАгальцовМ. В.AgaltsovM. V.

Агальцов Михаил Викторович — кандидат медицинских наук, старший научный сотрудник отдела фундаментальных и прикладных аспектов ожирения

Петроверигский пер., д. 10, стр. 3, Москва, 101990

Mikhail V. Agaltsov, MD, PhD, Senior Researcher, Department of Fundamental and Applied Aspects of Obesity

10-3 Petroverigskiy lane, Moscow, 101990

agaltsov@rambler.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр профилактической медицины» Министерства здравоохранения Российской ФедерацииРоссияNational Medical Research Centre for Preventive MedicineRussian Federation201921112019256604612Copyright © Агальцов М.В., 20202020Агальцов М.В.Agaltsov M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1779

Самыми распространенными методами диагностики нарушений дыхания во сне являются полисомнография (ПСГ) и кардиореспираторное (респираторное) мониторирование (КРМ) сна. ПСГ с момента создания занимает место «золотого» стандарта диагностики дыхательных событий во сне. В настоящее время КРМ во время сна получает все более широкое распространение как диагностический метод с минимальным набором параметров для определения дыхательных событий во сне. Использование КРМ обусловлено двумя причинами: возросшей потребностью в инструментальном обследовании из-за широкого распространения нарушений дыхания в популяции и условиями применения метода (простота использования, необязательность наличия лаборатории сна, более низкая себестоимость). Однако не у всех пациентов метод даст приемлемый результат. Потенциальными ограничениями являются отсутствие регистрации сна (информации о структуре сна и реакции на нарушения дыхания), контроля за исследованием со стороны медицинского персонала и нередко — датчика положения тела. Эти факторы влияют на оценку степени тяжести болезни и верификацию определенных форм заболевания. В настоящее время сформировались новые методы скрининга апноэ во время сна, основанные на современных инновационных технологиях и доступные в практической медицине. К ним нужно отнести определение наличия дыхательных событий по холтеровскому мониторированию электрокардиограммы во время сна, распознавание храпа и остановок дыхания во сне по аудиометрической записи сигнала и определение наличия апноэ по движениям во время сна (актиграфии).

Polysomnography and cardiorespiratory (respiratory) sleep monitoring are the most common diagnostic methods for respiratory sleep disorders. Polysomnography traditionally takes the place of the “gold” standard for detection of all types of respiratory events since its inception. Currently, cardiorespiratory monitoring of sleep is becoming more widespread as a diagnostic method with a minimum set of parameters for determining respiratory events during sleep. The increased use of cardiorespiratory (respiratory) monitoring of sleep is due to 2 reasons: the increased need for diagnosis due to the wide occurrence of respiratory disorders in the population and the conditions of the method (simple use, the need for a sleep laboratory, cheaper cost). However, the method is not indicated to all patients. Potential limitations for cardiorespiratory monitoring of sleep are the lack of sleep recording (information about the structure of sleep and reactions of sleep to respiratory disorders), monitoring of the study by medical personnel, and absence of body position sensor. These factors influence the assessment of the severity of the disease and the verification of certain forms of the disease. Currently, new methods of screening sleep apnea have been formed, based on modern innovative technologies and available in practical medicine. These include the determination of the presence of respiratory events be ECG Holter monitoring during sleep, the recognition of snoring and respiratory events in sleep from an audiometric signal recording and the determination of the probability of apnea with the help of registration movements during sleep (actigraphy).

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The authors declare that there are no conflicts of interest present.