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Review
. 2017 Jun;13(2):e37-e45.
doi: 10.1183/20734735.008817.

The Use of Tracheal Sounds for the Diagnosis of Sleep Apnoea

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Free PMC article
Review

The Use of Tracheal Sounds for the Diagnosis of Sleep Apnoea

Thomas Penzel et al. Breathe (Sheff). .
Free PMC article

Abstract

Tracheal sounds have been the subject of many research studies. In this review, we describe the state of the art, original work relevant to upper airways obstruction during sleep, and ongoing research concerning the methods used when analysing tracheal sounds. Tracheal sound sensors are a simple and noninvasive means of measurement and are more reliable than other breathing sensors. Developments in acoustic processing techniques and enhancements in tracheal sound signals over the past decade have led to improvements in the accuracy and clinical relevance of diagnoses based on this technology. Past and current research suggests that they may have a significant role in the diagnosis of obstructive sleep apnoea.

Key points: Tracheal sounds are currently a topic of significant interest but are not yet used in most routine sleep study systems.Measured at the suprasternal notch, tracheal sounds can provide reliable information on breathing sounds, snoring sounds and respiratory efforts.Tracheal sounds may be used as a noninvasive method of studying abnormalities of the upper airways during wakefulness.

Educational aims: To understand the principles of tracheal sound measurement and analysis.To highlight the importance of tracheal sounds for the diagnosis of sleep apnoea-hypopnoea syndrome.To present the most relevant clinical studies that have validated the use of tracheal sound sensors and to make future clinical validation studies possible.

Conflict of interest statement

Conflict of interest Disclosures can be found alongside this article at breathe.ersjournals.com

Figures

Figure 1
Figure 1
Automatic breathing sound respiratory cycle delimitation using envelope detection techniques. The beginning and the end of inspiration and expiration are properly detected and correspond closely with the respiratory cycle delimitation on the nasal pressure signal as well as the RIP signals. Tho/Abd: thoracoabdominal.
Figure 2
Figure 2
Presentation of a tracheal sound transducer. a) Diagram of the PneaVoX sensor that uses both an acoustic sensor and an SSP sensor. The sensors are inserted in a protective plastic housing to ensure an airtight acoustic chamber between the skin and the transducer. b) The sensor. c) Attachment of tracheal sound sensors to the skin using double-faced tape with an adhesive bandage over the sensor.
Figure 3
Figure 3
Detection of three consecutive obstructive apnoeas using the PneaVoX tracheal sound sensor. 1) Absence of tracheal sound (absence of respiratory cycles on the flow sound intensity and the snoring intensity signals). 2) Absence of oronasal flow on the thermistor signal. 3) Absence of nasal pressure on the nasal pressure signal.
Figure 4
Figure 4
A respiratory event with the criteria for hypopnoea without snoring sounds. Persistence of respiratory cycles in the flow sound signal but reduced in amplitude both at inspiration and expiration.
Figure 5
Figure 5
Example of a mixed apnoea where respiratory efforts are absent at the beginning of the event and resume before the event finishes. The respiratory efforts evaluated with the SSP are confirmed by the RIP signals as well as by the oesophageal pressure.
Figure 6
Figure 6
Detection of oral breathing using tracheal sounds. During expiration, the nasal pressure signal is null while the sound signal remains present. The oral expiration detected by the tracheal sound signal is confirmed by the thermistor signal, which shows respiratory variations.

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References

    1. Berry RB, Brooks R, Gamaldo CE, et al. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and technical specifications. Version 2.1. Darien, American Academy of Sleep Medicine, 2014.
    1. Goodwin JL, Enright PL, Kaemingk KL, et al. Feasibility of using unattended polysomnography in children for research – report of the Tucson Children’s Assessment of Sleep Apnea study (TuCASA). Sleep 2001; 24: 937–944. - PubMed
    1. Redline S, Sanders MH, Lind BK, et al. Methods for obtaining and analyzing unattended polysomnography data for a multicenter study. Sleep Heart Health Research Group. Sleep 1998; 21: 759–767. - PubMed
    1. Chervin RD, Aldrich MS. Effects of esophageal pressure monitoring on sleep architecture. Am J Respir Crit Care Med 1997; 156: 881–885. - PubMed
    1. Solà-Soler J, Fiz JA, Morera J, et al. Multiclass classification of subjects with sleep apnoea-hypopnoea syndrome through snoring analysis. Med Eng Phys 2012; 34: 1213–1220. - PubMed

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