Stradling J R, Crosby J H
Osler Chest Unit, Churchill Hospital, Oxford.
Thorax. 1991 Feb;46(2):85-90. doi: 10.1136/thx.46.2.85.
One thousand and one men, aged 35-65 years, were identified from the age-sex register of one group general practice. Over four years 900 men were visited at home and asked questions about symptoms potentially related to sleep apnoea and snoring. Height, weight, neck circumference, resting arterial oxygen saturation (SaO2), and spirometric values were also determined. All night oximetry was then performed at home and the tracing analysed for the number of dips in SaO2 of more than 4%. Subjects with more than five dips of 4% SaO2 or more per hour were invited for sleep laboratory polysomnography. Seventeen per cent of the men admitted to snoring "often." Multiple linear regression techniques identified and ranked neck circumference (r2 = 7.2%), cigarette consumption (r2 = 3.4%), and nasal stuffiness (r2 = 2%) as the only significant independent predictors of snoring. Together these account for at least a sixfold variation in the likelihood of being an "often" snorer. Forty six subjects (5%) had greater than 4% SaO2 dip rates of over five an hour and 31 of these had full sleep studies. Three subjects had clinically obvious and severe symptomatic obstructive sleep apnoea, giving a prevalence of three per 1001 men (0.3%; 95% confidence interval 0.07-0.9%). Eighteen men had obstructive sleep apnoea only when supine and in 10 the cause of the SaO2 dipping on the original home tracing was not elucidated. The greater than 4% SaO2 dip rates correlated with the history of snoring. Multiple linear regression techniques identified and ranked neck circumference (r2 = 7.9%), alcohol consumption (r2 = 3.7%), age (r2 = 1%) and obesity (r2 = 1%) as the only significant independent predictors of the rate of overnight hypoxic dipping. This study shows that snoring in this randomly selected population correlates best with neck size, smoking, and nasal stuffiness. Obstructive sleep apnoea, defined by nocturnal hypoxaemia, correlates best with neck size and alcohol, and less so with age and general obesity.
从一组普通科的年龄性别登记册中识别出1001名年龄在35至65岁之间的男性。在四年时间里，对900名男性进行了家访，并询问了他们与睡眠呼吸暂停和打鼾可能相关的症状。还测定了身高、体重、颈围、静息动脉血氧饱和度（SaO2）和肺功能值。然后让他们在家中进行整夜血氧饱和度监测，并分析记录中SaO2下降超过4%的次数。每小时SaO2下降超过4%达5次或更多次的受试者被邀请到睡眠实验室进行多导睡眠监测。17%的男性承认“经常”打鼾。多元线性回归技术确定并排列出颈围（r2 = 7.2%）、吸烟量（r2 = 3.4%）和鼻塞（r2 = 2%）是打鼾的仅有的重要独立预测因素。这些因素共同导致成为“经常”打鼾者的可能性至少有六倍的差异。46名受试者（5%）每小时SaO2下降超过4%的次数超过5次，其中31人进行了全面的睡眠研究。3名受试者有临床上明显且严重的症状性阻塞性睡眠呼吸暂停，患病率为每1001名男性中有3例（0.3%；95%置信区间0.07 - 0.9%）。18名男性仅在仰卧时出现阻塞性睡眠呼吸暂停，10名男性在家中最初监测记录中SaO2下降的原因未得到阐明。SaO2下降超过4%的次数与打鼾史相关。多元线性回归技术确定并排列出颈围（r2 = 7.9%）、饮酒量（r2 = 3.7%）、年龄（r2 = 1%）和肥胖（r2 = 1%）是夜间低氧血症发作率的仅有的重要独立预测因素。这项研究表明，在这个随机选择的人群中，打鼾与颈部尺寸、吸烟和鼻塞的相关性最强。由夜间低氧血症定义的阻塞性睡眠呼吸暂停与颈部尺寸和饮酒的相关性最强，与年龄和总体肥胖的相关性较小。
