EFFECTS OF ESOPHAGEAL PRESSURE MONITORING ON SLEEP ARCHITECTURE

Esophageal pressure (Pes) monitoring can be performed during polysomno graphy with a thin, water-filled catheter connected to a transducer. T he resulting quantitative assessment of respiratory effort aids in the diagnosis of sleep-related breathing disorders, but little is known a bout the potential effect of the procedure on sleep architecture. We m onitored Pes during polysomnography in 155 patients and compared their sleep architecture with that of 155 matched patients who slept withou t esophageal catheters. Cases were matched for age, sex, and severity of respiratory disturbance during sleep. Esophageal manometry was asso ciated with small but statistically significant (p < 0.05) decrements in total recording time, total sleep time, sleep efficiency, percent S tage 2 sleep, and percent rapid-eye-movement (REM) sleep, and with inc reases in latency to REM sleep, latency to persistent sleep, and perce nt Stage 3/4 sleep. The differences were of such small magnitude that their clinical significance is doubtful. The number of awakenings per hour of sleep, latency to sleep onset, and percent Stage 1 sleep were no different when esophageal manometry was used. We conclude that the effects of monitoring Pes on sleep architecture are minimal, and that the decision of whether or not to use the technique can be based to a large extent on whether quantitative information about respiratory eff ort will be useful.