Peppard Paul E, Ward Neil R, Morrell Mary J
Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin 53726, USA.
Am J Respir Crit Care Med. 2009 Oct 15;180(8):788-93. doi: 10.1164/rccm.200905-0773OC. Epub 2009 Jul 30.
Obesity increases the risk and severity of sleep-disordered breathing. The degree to which excess body weight contributes to blood oxygen desaturation during hypopneic and apneic events has not been comprehensively characterized.
To quantify the association between excess body weight and oxygen desaturation during sleep-disordered breathing.
A total of 750 adult participants in the Wisconsin Sleep Cohort Study were assessed for body mass index (BMI) (kg/m(2)) and sleep-disordered breathing. The amount of Sa(O(2)), duration, and other characteristics of 37,473 observed breathing events were measured during polysomnography studies. A mixed-effects linear regression model estimated the association of blood oxygen desaturation with participant-level characteristics, including BMI, gender, and age, and event-level characteristics, including baseline Sa(O(2)), change in Vt, event duration, sleep state, and body position.
BMI was positively associated with oxygen desaturation severity independent of age, gender, sleeping position, baseline Sa(O(2)), and event duration. BMI interacted with sleep state such that BMI predicted greater desaturation in rapid eye movement (REM) sleep than in non-REM sleep. Each increment of 10 kg/m(2) BMI predicted a 1.0% (SE, 0.2%) greater mean blood oxygen desaturation for persons in REM sleep experiencing hypopnea events associated with 80% Vt reductions.
Excess body weight is an important predictor of the severity of blood oxygen desaturation during apnea and hypopnea events, potentially exacerbating the impact of sleep-disordered breathing in obese patients.
肥胖会增加睡眠呼吸紊乱的风险和严重程度。超重对呼吸暂停和低通气事件期间血液氧饱和度降低的影响程度尚未得到全面描述。
量化超重与睡眠呼吸紊乱期间氧饱和度降低之间的关联。
对威斯康星睡眠队列研究中的750名成年参与者进行体重指数（BMI）（kg/m²）和睡眠呼吸紊乱评估。在多导睡眠图研究期间，测量了37473次观察到的呼吸事件的血氧饱和度（SaO₂）、持续时间和其他特征。混合效应线性回归模型估计了血氧饱和度降低与参与者水平特征（包括BMI、性别和年龄）以及事件水平特征（包括基线SaO₂、潮气量变化、事件持续时间、睡眠状态和体位）之间的关联。
BMI与氧饱和度降低的严重程度呈正相关，不受年龄、性别、睡眠姿势、基线SaO₂和事件持续时间的影响。BMI与睡眠状态存在交互作用，即BMI预测快速眼动（REM）睡眠中的氧饱和度降低程度大于非REM睡眠。对于经历与潮气量降低80%相关的低通气事件的REM睡眠者，BMI每增加10kg/m²，平均血氧饱和度降低幅度就会增加1.0%（标准误，0.2%）。
超重是呼吸暂停和低通气事件期间血氧饱和度降低严重程度的重要预测因素，可能会加剧肥胖患者睡眠呼吸紊乱的影响。
