Preprint Article Version 2 This version is not peer-reviewed

Energy Conversion Monitoring in Skin Tissue: A More Sensitive Measure of Hypoxia Occurring With Sleep Disordered Breathing Than Pulse Oximetry

Version 1 : Received: 5 March 2019 / Approved: 7 March 2019 / Online: 7 March 2019 (10:19:48 CET)
Version 2 : Received: 15 August 2019 / Approved: 16 August 2019 / Online: 16 August 2019 (06:27:46 CEST)

How to cite: Hatch, G.M..; Ashbrook, L..; Prather, A.A.; Krystal, A.D.. Energy Conversion Monitoring in Skin Tissue: A More Sensitive Measure of Hypoxia Occurring With Sleep Disordered Breathing Than Pulse Oximetry. Preprints 2019, 2019030087 (doi: 10.20944/preprints201903.0087.v2). Hatch, G.M..; Ashbrook, L..; Prather, A.A.; Krystal, A.D.. Energy Conversion Monitoring in Skin Tissue: A More Sensitive Measure of Hypoxia Occurring With Sleep Disordered Breathing Than Pulse Oximetry. Preprints 2019, 2019030087 (doi: 10.20944/preprints201903.0087.v2).

Abstract

Pulse oximetry is the current standard for detecting drops in arterial blood oxygen saturation (SpO2) associated with obstructive sleep apnea and hypopnea events in polysomnographic (PSG) testing. In cases of hypoxic challenge, such as occurs during apneic events, regulatory mechanisms restrict blood flow to the skin to preferentially maintain SpO2 for more vital organs. As a result, a measure related to skin tissue oxygenation is likely to be more sensitive to inadequate breathing during sleep than pulse oximetry. Energy Conversion Monitoring (ECM) provides a method for measuring skin tissue oxygen-dependent energy conversion and, as such, is promising for more sensitively detecting sleep disordered breathing (SDB) events compared to pulse oximetry. We hypothesized that ECM would detect hypoxia occurring with SDB events associated with drops in SpO2 but also would detect hypoxic challenge occurring with SDB events not associated with drops in SpO2 (hypopneas defined by a drop in nasal pressure occurring in conjunction with an arousal, respiratory-related arousals, and primary snoring). Primary snoring is of particular interest with respect to the potential of ECM because it is statistically associated with co-morbidities of SDB, such as hypertension, but is not considered pathological because of the lack of a proximal measure of pathology occurring with PSG. In this article we review ECM technology and methodology, present preliminary data indicating that it detects hypoxia occurring in the skin during SDB events that is not detected as blood desaturation by pulse oximetry, and make the case that it is a promising tool for identifying pathology occurring at the mild end of the SDB spectrum.

Subject Areas

tissue hypoxia; sleep disordered breathing; primary snoring; molecular tissue oximeter

Comments (1)

Comment 1
Received: 16 August 2019
Commenter: Aric Prather
Commenter's Conflict of Interests: Author
Comment: We have altered the title, abstract, and included additional data to this manuscript. The paper is reframed as a proof of concept distinguishing this energy conversion monitoring in skin from traditional pulse oximetry.
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