The influence of pharyngeal and esophageal pressure measurements on the parameters of polysomnography

Sleep-disordered breathing (SDB) is highly prevalent and accompanied by a considerable reduction in quality of life and an increase in cardiovascular morbidity and mortality. To diagnose SDB and to assess the localization of an airway obstruction, multichannel pressure measurements in the pharynx and esophagus have been used but are still under debate. Specifically, these devices are often labeled to be uncomfortable for patients and to influence the parameters of sleep recordings. The aims of the current study were to determine the tolerability of multilevel pressure measurement and to assess their impact on the parameters of polysomnography (PSG). Patients who were referred for two nights of standard PSG for diagnostic purposes were included. The device for multilevel pressure recordings was applied in addition to PSG on one of the two nights according to a randomization protocol. Tolerability of the device was assessed and the most relevant outcome measures of PSG were compared between the nights with and without the pressure sensor. All polysomnographic data were analyzed by the same trained observer who was blinded to the presence of the pressure catheter. Fifty-one patients were included in the trial. Ten of the patients tolerated insertion of the pressure catheter but complained about persisting discomfort during the night, requiring removal of the device. Forty-one patients tolerated the multilevel pressure transducer, which is equivalent to a tolerability of 80 %. The results of the sleep parameters are based on the data of 31 patients. The pressure device minimally influenced the outcome data of the PSG. None of the recorded differences however were clinically relevant or statistically significant. Pressure measurements with devices of small diameter (≈2 mm) are well accepted by patients and have a tolerability of at least 80 %. The impact of multilevel pressure recordings on objective sleep parameters is negligible. The study strongly supports the use of multilevel pressure recordings and disproves the most relevant objections against their use.