Aydoğdu Müge, Ciftçi Bülent, Firat Güven Selma, Ulukavak Ciftçi Tansu, Erdoğan Yurdanur
Atatürk Chest Disease and Chest Surgery Research and Training Hospital, Ankara, Turkey.
Tuberk Toraks. 2006;54(3):213-21.
In our study we aimed to examine the sleep structure, oxygenation and breathing pattern in interstitial lung disease (ILD) patients. We also aimed to determine whether relevance between the advanced disease and the sleep disorders exists and whether polysomnography is necessary in those patients. A total of 37 patients were examined in the study and whole night standard polysomnography was performed to all. Polysomnography results revealed that, total sleep time, time spent in NREM sleep stage III and IV, and in REM sleep were decreased. The patients had poor sleep efficiency and they spent more time as wake after sleep onset (WASO). Severe oxygen desaturations were detected during sleep and statistically significant positive correlations were found between mean awake O2 saturation and mean and lowest sleep O2 saturations. Clinical, Radiological and Physiological (CRP) scoring system was used to assess the disease stage, whether advanced or not, and statistically significant negative correlations were found between CRP score and awake and sleep O2 saturations. Obstructive sleep apnea syndrome (OSAS) was diagnosed in 24 (64.9%) patients. In those patients it was found that not the apneas but the hypopneas predominate. No difference was found among body mass indices (BMI) between the patients with and without OSAS. As a result it was concluded that a sleep study should be considered as part of the overall assessment in managing patients with ILD, and is especially indicated if there is incipient pulmonary hypertension, cor pulmonale and nocturnal arrhythmia despite normal awake blood gas tensions and symptoms as snoring and excessive day time sleepiness.
在我们的研究中,我们旨在检查间质性肺疾病(ILD)患者的睡眠结构、氧合和呼吸模式。我们还旨在确定晚期疾病与睡眠障碍之间是否存在关联,以及这些患者是否需要进行多导睡眠图检查。该研究共检查了37例患者,并对所有人进行了整夜标准多导睡眠图检查。多导睡眠图结果显示,总睡眠时间、在非快速眼动睡眠III期和IV期以及快速眼动睡眠期所花费的时间均减少。患者的睡眠效率较差,且睡眠开始后清醒时间(WASO)更长。睡眠期间检测到严重的氧饱和度下降,并且在清醒时平均氧饱和度与睡眠时平均和最低氧饱和度之间发现了具有统计学意义的正相关。使用临床、放射学和生理学(CRP)评分系统来评估疾病阶段是否为晚期,并且在CRP评分与清醒和睡眠时氧饱和度之间发现了具有统计学意义的负相关。24例(64.9%)患者被诊断为阻塞性睡眠呼吸暂停低通气综合征(OSAS)。在这些患者中发现,以呼吸浅慢而不是呼吸暂停为主。有OSAS和无OSAS的患者之间体重指数(BMI)无差异。结果得出结论,对于ILD患者的管理,应将睡眠研究视为整体评估的一部分,尤其是在清醒时血气张力正常但存在初发性肺动脉高压、肺心病和夜间心律失常以及打鼾和白天过度嗜睡等症状时,更应进行睡眠研究。