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外部升温对睡眠呼吸暂停/低通气综合征患者睡眠结构无影响。

Lack of effect of external warming on sleep architecture in sleep apnea/hypopnea syndrome.

作者信息

Dowdell W T, Javaheri S

机构信息

Pulmonary Section, Veterans Affairs Medical Center, Cincinnati, Ohio.

出版信息

Am Rev Respir Dis. 1992 Jan;145(1):137-40. doi: 10.1164/ajrccm/145.1.137.

DOI:10.1164/ajrccm/145.1.137
PMID:1731577
Abstract

Sleep apnea/hypopnea syndrome (SAHS) is characterized by nocturnal apneas (A) and/or hypopneas (H) occurring in various sleep stages. However, these disordered breathing events (DBE) occur rarely in slow-wave sleep (SWS) and are most severe in rapid eye movement (REM) sleep when severe hypoxemia results. Several studies have shown that a rise in body temperature by external warming, induced according to a specific protocol, affects normal human sleep architecture by diminishing the time spent in REM and increasing the time spent in SWS. The purpose of this study was to determine if external warming is as effective in sleep apneic patients in decreasing REM and increasing SWS, hoping that DBE and hypoxemia may diminish. Seven newly diagnosed patients were studied two more nights, on one of which (selected randomly) the sleep study was preceded by sitting in a warm bathtub with temperature of 41 degrees C for 1/2 h, 2 1/2 h before the start of sleep study. The mean maximum rise in oral temperature with warm bath was 2.0 +/- 0.4 degrees C. Total bed time (min) and sleep efficiency, REM, and SWS (%) were, respectively, 320 +/- 17 (SD), 81 +/- 8, 19 +/- 7, and 1.2 +/- 1.1 for the control (C) and 339 +/- 33, 79 +/- 11, 19 +/- 5, and 2.4 +/- 1.6 for the bath (B) night. In both C and B, the lowest O2 saturation (%) occurred in REM sleep and was 78 +/- 7 and 77 +/- 9, respectively. Comparing respective paired values between C and B, no significance was found.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

睡眠呼吸暂停/低通气综合征(SAHS)的特征是在各个睡眠阶段出现夜间呼吸暂停(A)和/或低通气(H)。然而,这些呼吸紊乱事件(DBE)在慢波睡眠(SWS)中很少发生,而在快速眼动(REM)睡眠中最为严重,此时会导致严重的低氧血症。多项研究表明,按照特定方案通过外部升温使体温升高,会减少REM睡眠时长并增加SWS睡眠时长,从而影响正常人类的睡眠结构。本研究的目的是确定外部升温对睡眠呼吸暂停患者减少REM睡眠和增加SWS睡眠是否同样有效,期望能减少DBE和低氧血症。对7名新诊断的患者进行了另外两晚的研究,其中一晚(随机选择)在睡眠研究开始前2个半小时,让患者坐在温度为41摄氏度的温浴缸中1/2小时。温水浴后口腔温度的平均最大升高为2.0±0.4摄氏度。对照(C)夜和温水浴(B)夜的总卧床时间(分钟)、睡眠效率、REM睡眠和SWS睡眠(%)分别为320±17(标准差)、81±8、19±7和1.2±1.1,以及339±33、79±11、19±5和2.4±1.6。在C夜和B夜,最低血氧饱和度(%)均出现在REM睡眠中,分别为78±7和77±9。比较C夜和B夜各自的配对值,未发现显著差异。(摘要截选至250字)

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