Respiratory challenge induces high frequency spiking on the static charge sensitive bed (SCSB)

Abstract

The static charge sensitive bed (SCSB) is a simple and noninvasive device used for the detection of sleep apnoea. In addition to episodes of apnoea or hypopnoea, heavy snorers commonly present with episodes of high frequency spiking on the SCSB. These spiking episodes have been claimed to represent partial upper airway obstruction during sleep, but the mechanism of their appearance is not known. We studied the SCSB spiking phenomenon in awake subjects during experimental respiratory challenge. One female and five male volunteers were studied whilst breathing freely, during hypoxia, hypercapnia and inspiratory and expiratory loading. Oxygen saturation, end-tidal carbon dioxide tension, minute ventilation, oesophageal pressure, electrocardiographic activity (ECG), blood pressure and the SCSB signals were monitored. During free breathing, the SCSB high frequency signal consisted of low amplitude complexes with close time relationship to the cardiac cycle. During respiratory challenge, spiking occurred. These spikes showed no time relationship to the cardiac cycle, but were time-linked to the onset of inspiration or expiration. Spike amplitude correlated with breathing frequency (r2 = 0.59; p < 0.005) and variation in oesophageal pressure (r2 = 0.57; p < 0.005). We conclude that during quiet, unobstructed breathing the static charge sensitive bed high frequency signal represents cardiac activity (ballistocardiogram), whereas during high-drive breathing high frequency spikes are produced. These spikes are respiratory in origin and are likely to represent fast components of respiratory movements. Our results support the use of static charge sensitive bed spiking as a noninvasive measure of breathing stimulation.