Selva-O'Callaghan Albert, Sampol Gabriel, Romero Odile, Lloberes Patricia, Trallero-Araguás Ernesto, Vilardell-Tarrés Miquel
Internal Medicine Department, Vall D'Hebron General Hospital, Universitat Autonoma Barcelona, C/Siracusa No. 12 Bis A, Barcelona, Spain.
Muscle Nerve. 2009 Feb;39(2):144-9. doi: 10.1002/mus.21204.
The purpose of this study was to determine the frequency of obstructive sleep apnea in patients with inflammatory myopathy. An observational and prospective study was performed on a cohort of adult patients with inflammatory myopathy followed at a specialized outpatient clinic. Sixteen consecutive adult patients were evaluated by the Epworth Sleepiness Scale (ESS) and by complete polysomnography study. Disease activity and severity were assessed using the Myositis Disease Activity Assessment Tool (MDAAT) and Myositis Damage Index (MDI), respectively. Associations between sleep parameters and other factors were calculated using the chi-square test, Fisher's exact test, Mann-Whitney U-test, and Wilcoxon's test. A serum autoantibody profile was determined for all patients. The mean apnea-hypopnea index was 28.7 (23.8), and 14 patients (87%) had an apnea-hypopnea index >5. The mean frequency of respiratory arousals was 20.1 (12.5). Eleven (68%) patients reported frequently-always snoring, and 3 (19%) had excessive daytime sleepiness (ESS >10). Seven patients were offered continuous positive airway pressure (CPAP) therapy; 4 tolerated the procedure well and reported a clear improvement in daytime sleepiness and/or sleep quality. No significant association was observed between the apnea-hypopnea index and clinical or immunological groups. Dysphagia, disease activity, and disease severity were not significantly associated with any sleep parameters. The frequency of obstructive sleep apnea in adult patients with inflammatory myopathy is high. The possibility that these alterations play a role in persistent fatigue in these patients cannot be ruled out.
本研究的目的是确定炎性肌病患者中阻塞性睡眠呼吸暂停的发生率。对在一家专业门诊随访的成年炎性肌病患者队列进行了一项观察性前瞻性研究。连续16例成年患者接受了爱泼华嗜睡量表（ESS）评估和完整的多导睡眠图研究。分别使用肌炎疾病活动评估工具（MDAAT）和肌炎损伤指数（MDI）评估疾病活动度和严重程度。使用卡方检验、Fisher精确检验、Mann-Whitney U检验和Wilcoxon检验计算睡眠参数与其他因素之间的关联。对所有患者进行了血清自身抗体谱检测。平均呼吸暂停低通气指数为28.7（23.8），14例患者（87%）的呼吸暂停低通气指数>5。呼吸唤醒的平均频率为20.1（12.5）。11例患者（68%）报告经常-总是打鼾，3例患者（19%）有日间过度嗜睡（ESS>10）。7例患者接受了持续气道正压通气（CPAP）治疗；4例患者对该治疗耐受良好，并报告日间嗜睡和/或睡眠质量有明显改善。未观察到呼吸暂停低通气指数与临床或免疫组之间存在显著关联。吞咽困难、疾病活动度和疾病严重程度与任何睡眠参数均无显著关联。成年炎性肌病患者中阻塞性睡眠呼吸暂停的发生率很高。不能排除这些改变在这些患者持续性疲劳中起作用的可能性。
