Cheshire K, Engleman H, Deary I, Shapiro C, Douglas N J
Department of Psychiatry, University of Edinburgh, Scotland.
Arch Intern Med. 1992 Mar;152(3):538-41.
Patients with sleep apnea/hypopnea syndrome commonly demonstrate impaired daytime performance. In a prospective study, 29 patients with sleep apnea/hypopnea syndrome were assessed polysomnographically to determine the relationship of cognitive performance and daytime sleepiness with sleep disruption, hypoxemia, and mood. Deterioration of cognitive performance correlated significantly with increasing severity of nocturnal breathing irregularity, magnitude of nocturnal hypoxemia, and extent of sleep disruption. Multiple regression analysis identified frequency of apneas plus hypopneas and of arousal and the extent of nocturnal hypoxemia as the variables most strongly associated with cognitive deficits. Anxiety and depression also contributed to this impairment. Objective daytime sleepiness was not significantly associated with nocturnal variables. This study showed that the frequency of breathing irregularities and the extent of both sleep disruption and nocturnal hypoxemia are important in determining daytime function in patients with sleep apnea/hypopnea syndrome. All of these factors should be considered when deciding which patients require treatment.
睡眠呼吸暂停/低通气综合征患者通常表现出白天功能受损。在一项前瞻性研究中，对29例睡眠呼吸暂停/低通气综合征患者进行了多导睡眠图评估，以确定认知功能和白天嗜睡与睡眠中断、低氧血症及情绪之间的关系。认知功能恶化与夜间呼吸不规则严重程度增加、夜间低氧血症程度及睡眠中断程度显著相关。多元回归分析确定呼吸暂停加低通气的频率、觉醒频率及夜间低氧血症程度是与认知缺陷最密切相关的变量。焦虑和抑郁也导致了这种损害。客观的白天嗜睡与夜间变量无显著关联。该研究表明，呼吸不规则频率、睡眠中断程度及夜间低氧血症程度在决定睡眠呼吸暂停/低通气综合征患者的白天功能方面很重要。在决定哪些患者需要治疗时，所有这些因素都应予以考虑。
