Taşınabilir Uyku Kayıt Sistemleri (Portable Monitörizasyon)
Özet
Obstrüktif uyku apnesi (OUA), yetişkin ve çocukları etkileyen, nörokognitif ve kardiyovasküler problemlerle ilişkili yaygın bir halk sağlığı sorunudur. Altın standart olan laboratuvar ortamındaki tüm gece polisomnografisi (PSG); pahalı, teknik olarak karmaşık ve uzun bekleme sürelerine sahip olduğundan, taşınabilir monitörizasyon (PM) cihazlarına ilgi artmıştır. Amerikan Uyku Tıbbı Akademisi (AASM) tarafından kanalların sayı ve tipine göre Tip 2, Tip 3 ve Tip 4 olarak sınıflandırılan bu cihazlar, seçilmiş vakalarda PSG'ye alternatif sunar. Günümüz teknolojisiyle birlikte sensör tabanlı SCOPER sınıflaması da geliştirilmiştir. PM cihazları; daha ulaşılabilir olmaları, maliyet avantajı sağlamaları ve ev ortamında "ilk gece etkisini" azaltarak konfor sunmaları açısından avantajlıdır. Ancak veri kayıpları, geceler arası değişkenlik, uyanıklık sürelerinin tam ölçülememesi nedeniyle apne-hipopne indeksinin (AHİ) düşük hesaplanabilmesi ve eşlik eden ciddi kronik hastalıklarda güvenilirliğinin azalması gibi dezavantajları mevcuttur. Sonuç olarak PM, kesinlikle uyku tıbbı alanında sertifikalı hekimler tarafından, yandaş hastalığı olmayan ve yüksek olasılıkla OUA düşünülen seçilmiş hastalarda klinik değerlendirmeyle kombine olarak uygulanmalıdır.
Obstructive sleep apnea (OSA) is a prevalent public health issue affecting adults and children, associated with neurocognitive and cardiovascular complications. While in-laboratory full-night polysomnography (PSG) remains the gold standard, its high cost, technical complexity, and long waiting times have increased interest in portable monitoring (PM). Classified by the AASM into Types 2, 3, and 4 based on channel number and type, these devices offer an alternative to PSG in selected cases. Advances in technology have also introduced the sensor-based SCOPER classification system. PM provides significant advantages, including higher accessibility, lower diagnostic costs, and reduced "first-night effects" by allowing patients to sleep in their comfortable home environment. However, it has distinct limitations, such as data loss, night-to-night variability, and underestimation of the apnea-hypopnea index (AHI) due to the inability to measure exact sleep duration versus recording time. Furthermore, its reliability decreases in patients with severe comorbidities like pulmonary or neuromuscular diseases. Consequently, guidelines emphasize that PM should only be utilized under the supervision of certified sleep specialists, specifically for patients with a high pre-test probability of OSA and without significant comorbid conditions.
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