Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Respiration. 2011;82(2):136-41. doi: 10.1159/000321238. Epub 2010 Dec 8.
Continuous positive airway pressure (CPAP) therapy has been shown to be effective in alleviating the underlying obstruction as well as reducing patients' excessive sleepiness and improving their functioning and health-related quality of life. However, residual excessive sleepiness is observed in some patients even though CPAP therapy eliminates sleep apnea and desaturation.
The aim of this study was to determine the prognostic effect of actigraphic sleep-wake rhythm evaluation in the management of patients with obstructive sleep apnea syndrome (OSAS) treated with CPAP.
Eighteen patients with OSAS diagnosed by standard polysomnography (PSG; 48.1 ± 12.5 years) were enrolled in this study. The sleep-wake parameters were determined by actigraphy before and after 1 month of CPAP treatment, and results were compared with PSG data. In addition, data obtained before CPAP were compared with those measured after 1 month of CPAP treatment.
The total sleep time (TST) and sleep efficiency using PSG were significantly correlated with those using actigraphy. Bland-Altman plots of TST and sleep efficiency confirmed good agreement between PSG and actigraphy data. Sleep efficiency significantly improved following CPAP compared to baseline, and sleep fragmentation and sleep fragmentation >5 min determined by actigraphy were significantly lower during CPAP therapy than at baseline. Movement was significantly lower on CPAP therapy than at baseline.
Actigraphy provides a valuable sleep-wake rhythm assessment in outpatients with OSAS where PSG is difficult to perform.
持续气道正压通气（CPAP）治疗已被证明可有效缓解潜在的阻塞，减轻患者的过度嗜睡，并改善其功能和健康相关的生活质量。然而，一些患者即使接受 CPAP 治疗消除了睡眠呼吸暂停和低氧血症，仍存在残余的过度嗜睡。
本研究旨在确定在 CPAP 治疗的阻塞性睡眠呼吸暂停综合征（OSAS）患者管理中，基于活动记录仪的睡眠-觉醒节律评估的预后效果。
本研究纳入了 18 名经标准多导睡眠图（PSG；48.1±12.5 岁）诊断为 OSAS 的患者。在 CPAP 治疗前和治疗 1 个月后使用活动记录仪确定睡眠-觉醒参数，并将结果与 PSG 数据进行比较。此外，还比较了 CPAP 治疗前和治疗 1 个月后的数据。
PSG 测量的总睡眠时间（TST）和睡眠效率与活动记录仪测量的结果显著相关。TST 和睡眠效率的 Bland-Altman 图证实了 PSG 和活动记录仪数据之间的良好一致性。与基线相比，CPAP 治疗后睡眠效率显著提高，且通过活动记录仪确定的睡眠片段化和 >5 分钟的睡眠片段化显著降低。CPAP 治疗期间的活动水平显著低于基线。
在难以进行 PSG 的 OSAS 门诊患者中，活动记录仪可提供有价值的睡眠-觉醒节律评估。
