Sleep disordered breathing (SDB) during the early recovery phase after a stroke occurs commonly (60-70% of patients) and significantly adversely effects recovery. Current methods evaluating SDB are generally not available or often impede timely intervention. This project develops a device (SleepPod) that provides accurate, real-time analyses of SDB from 4 channels of information suitable for use in a neuro-intensive care unit (NICU) with post-stroke patients. The techniques and measurements as developed specifically to provide clinically meaningful 24-hour recording and data in the NICU differ somewhat from those standard for the NICU or for sleep medicine. The SleepPod enables SDB evaluation in the first day on the NICU and provides the information for clinical assessment of treatment need. In phase I the basic algorithms for real-time detection and recording were developed and evaluated producing excellent agreement with the standard polysomnogram for identification of SDB rates and types (average difference <2.4 SDB/hr). Phase II will refine the system as a bedside monitor, enhance detection of types of SDB, further improve accuracy of detection, develop real-time and logged history of SDB at a remote location (nursing station) and establish an alarm system to alert medical staff to sensor adjustment problems and to more severe SDB requiring review for treatment. This system will also provide retrospective presentation of data for clinical review as needed to guide treatment. The enhanced system will be compared to a polysomnogram in the NICU on post-stroke patients using two repeated evaluations. The data presentation forms will be developed in consultation with the NICU nursing and medical staff. The final product will be a self-contained bed-side unit about the size of an i-pod with detection, recording, display and data export to a remote monitor presenting updated data and alarms to the NICU staff. The system will be easily used by NICU staff without adjustments other than for alarms and sensor placement. Most patients in the first few days after a stroke have sleep apnea. Their repeated struggles to breathe stress the blood-vessel injury in the brain. This may make the brain injury worse. The new SleepPod will provide bedside detection of sleep apnea permitting rapid treatment preventing worsening of the brain injury. ? ? ?
