Service de Pneumologie et d'Oncologie Thoracique, CHU St Etienne, France.
Eur Respir J. 2010 Oct;36(4):842-8. doi: 10.1183/09031936.00078009. Epub 2010 Apr 8.
Sleep-related disorders represent an important health burden and their prevalence increases with age. In patients with snoring or sleepiness, the presence of expiratory flow limitation (EFL), determined via the negative expiratory pressure (NEP) method, is related to the apnoea/hypopnoea index (AHI). In this study, we examined whether EFL can be used to predict obstructive sleep apnoea syndrome (OSAS) in healthy asymptomatic older subjects. A group of 72-yr-old subjects (n = 448, 44% males) with a mean body mass index of 25.5±3.8 kg·m(-2) were examined. All subjects underwent spirometry, NEP (-5 cmH(2)O, sitting position) and ventilatory polygraphy (VP). Spirometry was within normal values in 88% of the group and EFL was present in 143 (32%) subjects with a higher prevalence in females (89 out of 249 versus 54 out of 199 in females and males, respectively). VP showed an AHI<15 h(-1) in 238 subjects (53%) and OSAS with an AHI ≥15 h(-1) in 47%. EFL was found in 15% of subjects with OSAS. Consequently, EFL had low sensitivity and specificity in the prediction of OSAS (31.4% and 67.7%, respectively). We conclude that the prevalence of EFL is elevated in healthy older subjects and cannot be used to predict the presence of sleep-related disorders in an older population.
睡眠相关障碍是一个重要的健康负担，其患病率随着年龄的增长而增加。在打鼾或嗜睡的患者中，通过呼气负压（NEP）法确定的呼气流量受限（EFL）与呼吸暂停/低通气指数（AHI）相关。在这项研究中，我们研究了 EFL 是否可用于预测健康无症状的老年人群中的阻塞性睡眠呼吸暂停综合征（OSAS）。一组 72 岁的受试者（n = 448，44%为男性），平均体重指数为 25.5±3.8 kg·m(-2)，接受了检查。所有受试者均进行了肺量测定，NEP（-5 cmH(2)O，坐姿）和通气多导睡眠图（VP）检查。88%的受试者肺量测定值正常，143 名（32%）受试者存在 EFL，女性的患病率更高（249 名女性中有 89 名，199 名男性中有 54 名）。VP 显示 238 名（53%）受试者的 AHI<15 h(-1)，47 名（15%）受试者的 AHI≥15 h(-1)，诊断为 OSAS。OSAS 患者中 15%存在 EFL。因此，EFL 对 OSAS 的预测敏感性和特异性均较低（分别为 31.4%和 67.7%）。我们的结论是，EFL 在健康的老年受试者中患病率升高，但不能用于预测老年人群中睡眠相关障碍的存在。
