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Título

Continuous monitoring of brain compliance during sleep: expanding the spectrum of polysomnographic variables.

Resumo

Background. Based on the principle of detecting small deformations of the skull caused by changes in intracranial pressure, a non-invasive monitoring method was developed. The aim of our study was to evaluate the possibility of performing continuous monitoring of brain compliance throughout the night, through pulse morphology (P1, P2, P3) of intracranial pressure synchronized to the other physiological variables routinely addressed in a type I sleep study.
Methods. After assembling the patient to perform the polysomnography, we positioned the device on her head. The patient was instructed to call us if there was any discomfort regarding the use of the device. The assessment of brain compliance was performed by the non-invasive intracranial pressure (NICP) method through the Brain4care® device throughout the night. Sleep assessment was performed using type I polysomnography (Alice 6 - Phillips Respironics® device). We used the AASM scoring rules to analyze the sleep study. We superimposed the graph representing the variation of the P2/P1 ratio with the hypnogram.
Results. The patient remained overnight with the sensor on her head. It did not move at any time during the monitoring. The recording duration was 5h 44min 42s. The useful pulses for evaluation were in the line above 60%. Only 6 minutes of the exam could not be analyzed due to the presence of artifacts interfering with the P1 and P2 waves. The P2/P1 variation graph was adequately superimposed on the hypnogram. In the morning, the patient reported no complaints related to device use. The signals recorded by the polysomnography equipment were not disturbed by the Brain4Care device.
Comments. In this pilot study, we were able to demonstrate the feasibility of including a sensor aimed at assessing brain compliance and performing continuous monitoring of its variation during sleep. The data shown here are part of a large project that involves analyzing the impact of obstructive sleep apnea on brain compliance. The data plotted on the hypnogram allowed a visual analysis of the P2/P1 ratio curve, which behaved as expected, considering the data that we have already obtained in the different sleep stages of monitoring this patient.
Conclusion. It was possible to monitor overnight brain compliance through the non-invasive device Brain4Care. The Brain4Care device did not determine interference in the signal captured for performing the polysomnography, preserving the quality of both assessments.

Palavras Chave

brain compliance; polysomnographic; Continuous monitoring, sleep.

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