Koo Brian B, Dostal Jesse, Ioachimescu Octavian, Budur Kumaraswamy
Division of Sleep Medicine, Cleveland Clinic Foundation, Cleveland, OH 44106, USA.
Sleep Breath. 2008 Aug;12(3):259-64. doi: 10.1007/s11325-007-0161-7. Epub 2007 Dec 11.
Sleep disordered breathing occurring predominantly in rapid eye movement REM sleep (rapid-eye-movement-related sleep-disordered breathing, REM SDB) is present in 10 to 36% of patients undergoing polysomnography (PSG) for suspected obstructive sleep apnea (O'Connor et al. in Am J Respir Crit Care Med 161:1465-1472, 2000; Resta et al. in J Respir Medicine 99:91-96, 2005; Haba-Rubio et al. in Chest 128:3350-3357, 2005; Juvelekian and Golish, American Academy of Sleep Medicine, abstract, 2004). We hypothesize that REM SDB is an age-related condition in women and, additionally, more prevalent in women than in men. Subjects with REM SDB were identified retrospectively among 1,540 obstructive sleep apnea (OSA) patients with an apnea-hypopnea index (AHI) >or= 5. Inclusion criteria for REM SDB were age >18, AHI >or= 5, NREM AHI < 15, and REM AHI/NREM AHI > 2. PSG data included sleep latency, REM latency, total sleep time (TST), AHI, REM AHI, NREM AHI, and sleep stage percentages. Demographic data and medical and psychiatric histories were also obtained. Statistical comparisons were made between men and women and women older and younger than 55 years, a marker for menopausal status. Two hundred twenty-one subjects fulfilled the criteria for REM SDB, yielding a prevalence of 14.4%. Overall, female apneics had a significantly higher prevalence of REM SDB than did men (24.5 vs 7.9%; p < 0.001). Younger women had a significantly higher prevalence than did older women (27.2 vs 18.6%; p = 0.008); younger men had a significantly higher prevalence of REM SDB than did older men (9.9 vs 4.5%; p = 0.002). Women were significantly older and more obese than were men. Younger women were more likely to be depressed and were significantly more obese than were older women. REM SDB is more prevalent in women than in men and more prevalent in men and women younger than 55 than those older than 55. In this population, women are more obese and older than men, while younger women were more obese than older women. These descriptive distinctions suggest differences in mechanism which may depend on gender and age.
主要发生在快速眼动（REM）睡眠期的睡眠呼吸障碍（快速眼动相关睡眠呼吸障碍，REM SDB）在10%至36%因疑似阻塞性睡眠呼吸暂停而接受多导睡眠图（PSG）检查的患者中存在（奥康纳等人，《美国呼吸与危重症医学杂志》161:1465 - 1472，2000年；雷斯塔等人，《呼吸医学杂志》99:91 - 96，2005年；哈巴 - 鲁维奥等人，《胸部》128:3350 - 3357，2005年；朱韦莱基安和戈利什，美国睡眠医学学会，摘要，2004年）。我们假设REM SDB在女性中是一种与年龄相关的疾病，此外，在女性中比在男性中更普遍。在1540名呼吸暂停低通气指数（AHI）≥5的阻塞性睡眠呼吸暂停（OSA）患者中，通过回顾性研究确定了患有REM SDB的受试者。REM SDB的纳入标准为年龄>18岁、AHI≥5、非快速眼动睡眠期AHI<15以及快速眼动睡眠期AHI/非快速眼动睡眠期AHI>2。PSG数据包括睡眠潜伏期、快速眼动睡眠潜伏期、总睡眠时间（TST）、AHI、快速眼动睡眠期AHI、非快速眼动睡眠期AHI以及睡眠阶段百分比。还获取了人口统计学数据以及医学和精神病史。对男性与女性以及年龄小于和大于55岁的女性（绝经状态的一个标志）进行了统计学比较。221名受试者符合REM SDB的标准，患病率为14.4%。总体而言，女性呼吸暂停患者中REM SDB的患病率显著高于男性（24.5%对7.9%；p<0.001）。年轻女性的患病率显著高于老年女性（27.2%对18.6%；p = 0.008）；年轻男性中REM SDB的患病率显著高于老年男性（9.9%对4.5%；p = 0.002）。女性比男性年龄显著更大且更肥胖。年轻女性比老年女性更易患抑郁症且显著更肥胖。REM SDB在女性中比在男性中更普遍，在年龄小于55岁的男性和女性中比在年龄大于55岁的人群中更普遍。在这个群体中，女性比男性年龄更大且更肥胖，而年轻女性比老年女性更肥胖。这些描述性差异表明机制上的差异可能取决于性别和年龄。
