Svensson Malin, Franklin Karl A, Theorell-Haglöw Jenny, Lindberg Eva
Department of Surgical Sciences, Otorhinolaryngology, Head and Neck Surgery, Uppsala University, Uppsala.
Department of Respiratory Medicine, University Hospital, Umeå, Sweden.
Chest. 2008 Nov;134(5):919-924. doi: 10.1378/chest.08-0847. Epub 2008 Aug 27.
The aim was to investigate the significance of snoring and sleep apnea on daytime symptoms in a population-based sample of women.
From the general population, 400 women aged 20 to 70 years were randomly selected, with oversampling of habitually snoring women. The women were investigated using full-night polysomnography and a questionnaire. The apnea-hypopnea index (AHI) was calculated, and women who acknowledged snoring loudly and disturbingly often or very often were considered habitual snorers.
Habitual snoring was independently related to excessive daytime sleepiness (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.31 to 3.99), to falling asleep involuntarily during the day (OR, 2.11; 95% CI, 1.06 to 4.21), to waking up unrefreshed (OR, 2.14; 95% CI, 1.30 to 3.52), to daytime fatigue (OR, 2.77; 95% CI, 1.54 to 4.99), and to a dry mouth on awakening (OR, 2.00; 95% CI, 1.22 to 3.27) after adjustment for AHI, age, body mass index (BMI), smoking, total sleep time, percentage of slow-wave sleep, and percentage of rapid eye movement (REM) sleep. An AHI > or = 15/h was only related to a dry mouth on awakening after adjustment for snoring, age, BMI, smoking, total sleep time, percentage of slow-wave sleep, and percentage of REM sleep (OR, 2.24; 95% CI, 1.14 to 4.40). An AHI of 5 to 15/h was not related to any daytime symptom.
Excessive daytime sleepiness and daytime fatigue are related to habitual snoring independent of the apnea-hypopnea frequency, age, obesity, smoking, and sleep parameters in a population-based sample of women, but not to the AHI. This indicates that snoring is an independent cause of excess daytime sleepiness and not merely a proxy for sleep apnea.
本研究旨在调查在一个基于人群的女性样本中，打鼾和睡眠呼吸暂停对日间症状的影响。
从普通人群中随机选取400名年龄在20至70岁之间的女性，其中习惯性打鼾的女性进行了过度抽样。对这些女性进行了整夜多导睡眠监测和问卷调查。计算呼吸暂停低通气指数（AHI），那些承认经常或非常经常大声且令人困扰地打鼾的女性被视为习惯性打鼾者。
在对AHI、年龄、体重指数（BMI）、吸烟、总睡眠时间、慢波睡眠时间百分比和快速眼动（REM）睡眠时间百分比进行调整后，习惯性打鼾与日间过度嗜睡（优势比[OR]，2.28；95%置信区间[CI]，1.31至3.99）、白天不由自主入睡（OR，2.11；95%CI，1.06至4.21）、醒来后未恢复精力（OR，2.14；95%CI，1.30至3.52）、日间疲劳（OR，2.77；95%CI，1.54至4.99）以及醒来时口干（OR，2.00；95%CI，1.22至3.27）独立相关。在对打鼾、年龄、BMI、吸烟、总睡眠时间、慢波睡眠时间百分比和REM睡眠时间百分比进行调整后，AHI≥15次/小时仅与醒来时口干相关（OR，2.24；95%CI，1.14至4.40）。AHI为5至15次/小时与任何日间症状均无关。
在一个基于人群的女性样本中，日间过度嗜睡和日间疲劳与习惯性打鼾独立相关，与呼吸暂停低通气频率、年龄、肥胖、吸烟和睡眠参数无关，但与AHI无关。这表明打鼾是日间过度嗜睡的独立原因，而不仅仅是睡眠呼吸暂停的替代指标。
