Awakening efficacy of a vibrotactile device in patients on homenocturnal ventilatory assistance and healthy subjects as family caregiverproxies

摘要

The objective of this study was to test the capacity of vibrotactile stimulationtransmitted to the wrist bones by a vibrating wristband to awaken healthyindividuals and patients requiring home mechanical ventilation during sleep.Healthy subjects (n = 20) and patients with central hypoventilation (CH)(Congenital Central Hypoventilation syndrome n = 7; non-genetic form of CH n =1) or chronic obstructive pulmonary disease (COPD) (n = 9), underwent afull-night polysomnography while wearing the wristband. Vibrotactile alarms weretriggered five times during the night at random intervals.Electroencephalographic (EEG), clinical (trunk lift) and cognitive (record thetime on a sheet of paper) arousals were recorded. Cognitive arousals wereobserved for 94% of the alarms in the healthy group and for 66% and 63% ofsubjects in the CH and COPD groups, respectively (p < 0.01). The percentageof participants experiencing cognitive arousals for all alarms, was 72% forhealthy subjects, 37.5% for CH patients and 33% for COPD patients (ns) (94%, 50%and 44% for clinical arousals (p < 0.01) and 100%, 63% and 44% for EEGarousals (p < 0.01)). Device acceptance was good in the majority of cases,with the exception of one CH patient and eight healthy participants. In summarythis study shows that a vibrotactile stimulus is effective to induce awakeningsin healthy subjects, but is less effective in patients, supporting the notionthat a vibrotactile stimulus could be an effective backup to a home mechanicalventilator audio alarm for healthy family caregivers.