Sleeping Center, Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, 215004, China.
Sleep Breath. 2011 Jan;15(1):129-35. doi: 10.1007/s11325-010-0337-4. Epub 2010 Feb 20.
The aim of this study was to characterize excessive daytime sleepiness (EDS) in a large cohort of Chinese patients with various severity of obstructive sleep apnea-hypopnea syndrome (OSAHS), and investigate its correlations with clinical/polysomnographic variables.
A total of 1,035 consecutive Chinese patients with snoring (mean age ± SD 45 ± 15 years, BMI 26.6 ± 4.3 kg/m(2)) were examined by overnight polysomnography, and subjective EDS was assessed using the Epworth Sleepiness Scale (ESS).
The 1,035 patients were compared according to severity of sleep-disordered breathing: AHI <5 (primary snoring group or normal overall AHI) (24.1%), AHI 5-20 (mild OSAHS, 21.7%), AHI >20-40 (moderate OSAHS 16.5%), and AHI >40 (severe OSAHS 37.7%). ESS score progressively increased as the severity of OSAHS aggravated among these patients. More severe OSAHS patients were characterized by EDS, nocturnal hypoxemia, and disruption of sleep structure. Progressive worsening of nocturnal hypoxemia was observed from mild to severe OSAHS patients with a strong correlation with ESS score. The stepwise multiple regression analysis performed to evaluate the correlations of individual clinical and polysomnographic variables with the ESS score revealed that the ESS score significantly correlated with the oxygen desaturation index (ODI), apnea-hypopnea index (AHI), and body mass index (BMI), and ODI was the strongest determinant of ESS score.
EDS is correlated with the severity of OSAHS. More severe patients are characterized by higher ESS score, higher BMI, and progressive worsening of nocturnal hypoxemia. Nocturnal hypoxemia is a major determinant of EDS in Chinese OSAHS patients.
本研究旨在描述不同严重程度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者中白天过度嗜睡（EDS）的特征，并探讨其与临床/多导睡眠图变量的相关性。
对 1035 例打鼾的中国患者（平均年龄±标准差 45±15 岁，BMI 26.6±4.3kg/m2）进行整夜多导睡眠图检查，并使用 Epworth 嗜睡量表（ESS）评估主观 EDS。
根据睡眠呼吸紊乱的严重程度对 1035 例患者进行比较：AHI<5（原发性打鼾组或总体 AHI 正常）（24.1%），AHI 5-20（轻度 OSAHS，21.7%），AHI>20-40（中度 OSAHS，16.5%），和 AHI>40（重度 OSAHS，37.7%）。随着 OSAHS 严重程度的加重，这些患者的 ESS 评分逐渐增加。更严重的 OSAHS 患者表现为 EDS、夜间低氧血症和睡眠结构中断。从轻度到重度 OSAHS 患者，夜间低氧血症逐渐恶化，与 ESS 评分呈强相关。进行逐步多元回归分析以评估个体临床和多导睡眠图变量与 ESS 评分的相关性，结果显示 ESS 评分与氧减指数（ODI）、呼吸暂停低通气指数（AHI）和体重指数（BMI）显著相关，而 ODI 是 ESS 评分的最强决定因素。
EDS 与 OSAHS 的严重程度相关。更严重的患者 ESS 评分更高、BMI 更高，且夜间低氧血症逐渐恶化。夜间低氧血症是中国 OSAHS 患者 EDS 的主要决定因素。
