Punjabi Naresh M, Bandeen-Roche Karen, Marx Jason J, Neubauer David N, Smith Philip L, Schwartz Alan R
Sleep. 2002 May 1;25(3):307-14.
Daytime sleepiness is common in patients with sleep-disordered breathing. Although respiratory events during sleep are associated with the occurrence of daytime sleepiness, the differential impact of these events during non-rapid eye movement (NREM) and rapid eye movement (REM) sleep on daytime sleepiness has not been well characterized.
To determine the effect of respiratory events during REM sleep and NREM sleep on daytime sleepiness, as assessed by the multiple sleep latency test (MSLT).
Cross-sectional study.
University-based sleep disorders laboratory.
Patients referred for polysomnography and daytime MSLT (n=1,821).
N/A.
The study sample was initially divided into quartiles based on the level of the apnea-hypopnea index (AHI) during NREM sleep. Within the first NREM-AHI quartile (NREM-AHI < 8.3 events/hr), the association between REM-related respiratory events and daytime sleepiness was examined using the method of Kaplan-Meier analysis and Cox proportional hazards regression. After adjusting for age, gender, body mass index, and the duration of NREM and REM sleep, REM-AHI was not associated with daytime sleepiness (Relative Risk: 1.01; 95%CI: 0.94-1.10). Similarly, no significant association was observed between REM-AHI and the MSLT in patients within the second through fourth NREM-AHI quartiles. In contrast, increasing severity of disordered breathing during NREM sleep was associated with daytime sleepiness. For a 10-point increase in NREM-AHI, the adjusted relative risks for daytime sleepiness in the second through fourth NREM-AHI quartile were 1.21 (95%CI: 1.01-1.46), 1.20 (95%CI: 1.05-1.37), and 1.10 (95%CI: 1.04-1.16), respectively.
Sleep-disordered breathing during NREM sleep, but not REM sleep, is associated with increased risk of daytime sleepiness.
日间嗜睡在睡眠呼吸障碍患者中很常见。虽然睡眠期间的呼吸事件与日间嗜睡的发生有关，但这些事件在非快速眼动（NREM）睡眠和快速眼动（REM）睡眠期间对日间嗜睡的不同影响尚未得到充分描述。
通过多次睡眠潜伏期试验（MSLT）评估REM睡眠和NREM睡眠期间呼吸事件对日间嗜睡的影响。
横断面研究。
大学睡眠障碍实验室。
转诊进行多导睡眠图和日间MSLT检查的患者（n = 1821）。
无。
研究样本最初根据NREM睡眠期间的呼吸暂停低通气指数（AHI）水平分为四分位数。在第一个NREM-AHI四分位数（NREM-AHI < 8.3次/小时）内，使用Kaplan-Meier分析和Cox比例风险回归方法检查与REM相关的呼吸事件和日间嗜睡之间的关联。在调整年龄、性别、体重指数以及NREM和REM睡眠持续时间后，REM-AHI与日间嗜睡无关（相对风险：1.01；95%CI：0.94 - 1.10）。同样，在第二至第四个NREM-AHI四分位数的患者中，未观察到REM-AHI与MSLT之间存在显著关联。相比之下，NREM睡眠期间呼吸障碍严重程度的增加与日间嗜睡有关。对于NREM-AHI每增加10分，第二至第四个NREM-AHI四分位数中日间嗜睡的调整后相对风险分别为1.21（95%CI：1.01 - 1.46）、1.20（95%CI：1.05 - 1.37）和1.10（95%CI：1.04 - 1.16）。
NREM睡眠而非REM睡眠期间的睡眠呼吸障碍与日间嗜睡风险增加有关。
