help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by DRINNAN, M. J.
Right arrow Articles by JOHN GIBSON, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by DRINNAN, M. J.
Right arrow Articles by JOHN GIBSON, G.

Am. J. Respir. Crit. Care Med., Volume 158, Number 2, August 1998, 358-362

Interobserver Variability in Recognizing Arousal in Respiratory Sleep Disorders

MICHAEL J. DRINNAN, ALAN MURRAY, CLIVE J. GRIFFITHS, and G. JOHN GIBSON

Departments of Regional Medical Physics and Respiratory Medicine, Freeman Hospital, Newcastle Upon Tyne, United Kingdom

Daytime sleepiness is a common consequence of repeated arousal in obstructive sleep apnea (OSA). Arousal indices are sometimes used to make decisions on treatment, but there is no evidence that arousals are detected similarly even by experienced observers. Using the American Sleep Disorders Association (ASDA) definition of arousal in terms of the accompanying electroencephalogram (EEG) changes, we have quantified interobserver agreement for arousal scoring and identified factors affecting it. Ten patients with suspected OSA were studied; three representative EEG events during each of light, slow-wave, and rapid-eye-movement (REM) sleep were extracted from each record (90 events total) and evaluated by experts in 14 sleep laboratories. Observers differed (ANOVA, p < 0.001) in the number of events scored as arousal (totals ranged from 23 to 53 of the 90 events). Overall agreement was moderate (kappa  = 0.47), but it was best for events during slow-wave sleep, moderate for REM, and poor for light sleep (kappa  = 0.60, 0.52, and 0.28, respectively). Agreement was unrelated to arousal duration. We conclude that the ASDA definition of arousal is only moderately repeatable. Account should be taken of this variability when results from different centers are compared.




This article has been cited by other articles:


Home page
 Proc Am Thorac SocHome page
W. T. McNicholas
Diagnosis of Obstructive Sleep Apnea in Adults
Proceedings of the ATS, February 15, 2008; 5(2): 154 - 160.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
G V Robinson, J R Stradling, and R J O Davies
Sleep {middle dot} 6: Obstructive sleep apnoea/hypopnoea syndrome and hypertension
Thorax, December 1, 2004; 59(12): 1089 - 1094.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
D Schlosshan and M W Elliott
Sleep * 3: Clinical presentation and diagnosis of the obstructive sleep apnoea hypopnoea syndrome
Thorax, April 1, 2004; 59(4): 347 - 352.
[Abstract] [Full Text] [PDF]

Home page
 J. Neurosci.Home page
H. Super, C. van der Togt, H. Spekreijse, and V. A. F. Lamme
Internal State of Monkey Primary Visual Cortex (V1) Predicts Figure-Ground Perception
J. Neurosci., April 15, 2003; 23(8): 3407 - 3414.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. I. PACK, J. E. BLACK, J. R. L. SCHWARTZ, and J. K. MATHESON
Modafinil as Adjunct Therapy for Daytime Sleepiness in Obstructive Sleep Apnea
Am. J. Respir. Crit. Care Med., November 1, 2001; 164(9): 1675 - 1681.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M.V. Smurra, M. Dury, G. Aubert, D.O. Rodenstein, and G. Liistro
Sleep fragmentation: comparison of two definitions of short arousals during sleep in OSAS patients
Eur. Respir. J., April 1, 2001; 17(4): 723 - 727.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. MORRELL, L. FINN, H. KIM, P. E. PEPPARD, M. SAFWAN BADR, and T. YOUNG
Sleep Fragmentation, Awake Blood Pressure, and Sleep-Disordered Breathing in a Population-based Study
Am. J. Respir. Crit. Care Med., December 1, 2000; 162(6): 2091 - 2096.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. ARGOD, J.-L. PÉPIN, R. P. SMITH, and P. LÉVY
Comparison of Esophageal Pressure with Pulse Transit Time as a Measure of Respiratory Effort for Scoring Obstructive Nonapneic Respiratory Events
Am. J. Respir. Crit. Care Med., July 1, 2000; 162(1): 87 - 93.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. N. KINGSHOTT, M. VENNELLE, C. J. HOY, H. M. ENGLEMAN, I. J. DEARY, and N. J. DOUGLAS
Predictors of Improvements in Daytime Function Outcomes with CPAP Therapy
Am. J. Respir. Crit. Care Med., March 1, 2000; 161(3): 866 - 871.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
E. N. Exar and N. A. Collop
The Upper Airway Resistance Syndrome
Chest, April 1, 1999; 115(4): 1127 - 1139.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. S. BENNETT, B. A. LANGFORD, J. R. STRADLING, and R. J. O. DAVIES
Sleep Fragmentation Indices as Predictors of Daytime Sleepiness and nCPAP Response in Obstructive Sleep Apnea
Am. J. Respir. Crit. Care Med., September 1, 1998; 158(3): 778 - 786.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 1998 American Thoracic Society 		  CCM abstracts