Dreher A, Patscheider M, Braun T
Klinikum der Ludwig-Maximilians-Universität München, Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, München, Germany.
Laryngorhinootologie. 2012 Mar;91(3):182-4. doi: 10.1055/s-0031-1283155. Epub 2011 Aug 29.
Obesity is a well established risk factor for developing an obstructive sleep apnea syndrome (OSAS). However, normal weighted patients can suffer from OSAS, too. This study compares breathing disorders and their effect on sleep of normal weighted and obese OSAS patients.
The main sleep parameters of 32 normal weighted OSAS patients (body mass index, BMI ≤ 25 kg/m2) were compared with those of 32 obese OSAS patients (BMI ≥ 35 kg/m2) with a virtually equal apnea-hypopnea index (AHI ± 3).
The mean AHI in both groups was 27.9/h (BMI ≤ 25 kg/m2) and 28.0/h (BMI ≥ 25 kg/m2), respectively. Sleep efficiency, relative percentages of sleep phases S1-S4 and REM, mean, minimal and maximal heart rate were not significantly different in statistic analysis in normal weighted and obese patients. Normal weighted OSAS patients had a higher apnea index (11.4 vs. 6.4, p=0.040), a higher minimal (81.3% vs. 71.7, p=0.003) and mean (94.9% vs. 92.8%, p=0.007) oxygen saturation, but a smaller hypopnea index (16.5 vs. 21.6, p=0.047) and a lower index of snoring (175.2 vs. 394.1, p<0.001) than their obese counterparts.
In OSAS patients with an equal AHI, the obese have fewer apneas, but more hypopneas, and a lower minimal oxygen saturation than normal weighted patients. The effect of OSAS on the sleep architecture, however, seems not to be associated with the patients' body weight.
肥胖是阻塞性睡眠呼吸暂停综合征(OSAS)公认的危险因素。然而,体重正常的患者也可能患阻塞性睡眠呼吸暂停综合征。本研究比较了体重正常和肥胖的阻塞性睡眠呼吸暂停综合征患者的呼吸障碍及其对睡眠的影响。
将32名体重正常的阻塞性睡眠呼吸暂停综合征患者(体重指数,BMI≤25kg/m²)的主要睡眠参数与32名肥胖的阻塞性睡眠呼吸暂停综合征患者(BMI≥35kg/m²)的主要睡眠参数进行比较,两组患者的呼吸暂停低通气指数(AHI±3)几乎相等。
两组患者的平均AHI分别为27.9次/小时(BMI≤25kg/m²)和28.0次/小时(BMI≥25kg/m²)。在体重正常和肥胖患者的统计分析中,睡眠效率、睡眠阶段S1-S4和快速眼动的相对百分比、平均心率、最低心率和最高心率无显著差异。体重正常的阻塞性睡眠呼吸暂停综合征患者的呼吸暂停指数较高(11.4对6.4,p=0.040),最低(81.3%对71.7,p=0.003)和平均(94.9%对92.8%,p=0.007)血氧饱和度较高,但低通气指数较小(16.5对21.6,p=0.047),打鼾指数较低(175.2对394.1,p<0.001)。
在呼吸暂停低通气指数相等的阻塞性睡眠呼吸暂停综合征患者中,肥胖患者的呼吸暂停较少,但低通气较多,最低血氧饱和度低于体重正常的患者。然而,阻塞性睡眠呼吸暂停综合征对睡眠结构的影响似乎与患者的体重无关。