Eun Young Gyu, Kwon Kee Hwan, Shin Seung Youp, Lee Kun Hee, Byun Jae Yong, Kim Sung Wan
Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kyunghee University, Dongdaemun-Gu, Seoul, Korea.
Otolaryngol Head Neck Surg. 2009 Apr;140(4):536-41. doi: 10.1016/j.otohns.2009.01.006.
To compare the anatomic features and the results of a multilevel surgery in patients with rapid eye movement-related obstructive sleep apnea (REM OSA) and non-REM OSA.
Cohort study of 90 consecutive mild or moderate OSA patients.
The apnea-hypopnea index (AHI) was also calculated during REM sleep (AHI(REM)) and during non-REM sleep (AHI(NREM)), and patients were classified as having REM OSA if their AHI(REM)/AHI(NREM) ratio was >2, otherwise they were classified as non-REM OSA patients. All patients underwent concurrent uvulopalatopharyngoplasty and a radiofrequency tongue base reduction procedure.
A total of 31.1 percent patients were classified as REM OSA and 68.9 percent patients as non-REM OSA. There were no differences in the anatomical features between two groups. However, the AHI, HI, and arousal index were significantly higher in the non-REM OSA group than in the REM OSA group. When a successful outcome was defined as a postoperative AHI <20 with at least a 50 percent reduction from the preoperative level, 50 percent of the patients with REM OSA and 35.5 percent of the patients with non-REM OSA met the criteria for a successful outcome.
REM OSA patients had milder obstructive sleep apnea, and multilevel surgery might be more effective in REM OSA patients.
比较快速眼动相关阻塞性睡眠呼吸暂停（REM OSA）患者和非快速眼动OSA患者的解剖学特征及多级手术结果。
对90例连续的轻度或中度OSA患者进行队列研究。
计算快速眼动睡眠期（AHI(REM)）和非快速眼动睡眠期（AHI(NREM)）的呼吸暂停低通气指数（AHI），若患者的AHI(REM)/AHI(NREM)比值>2，则分类为REM OSA患者，否则分类为非REM OSA患者。所有患者均同时接受悬雍垂腭咽成形术和射频舌根减容术。
共31.1%的患者被分类为REM OSA，68.9%的患者被分类为非REM OSA。两组间解剖学特征无差异。然而，非REM OSA组的AHI、HI及觉醒指数显著高于REM OSA组。若将手术成功定义为术后AHI<20且较术前水平至少降低50%，则50%的REM OSA患者和35.5%的非REM OSA患者达到手术成功标准。
REM OSA患者的阻塞性睡眠呼吸暂停较轻，多级手术对REM OSA患者可能更有效。
