Sleep Center at the Kuchwald Hospital, Chemnitz, Germany.
J Physiol Pharmacol. 2012 Jun;63(3):263-9.
Sleep disturbances in obstructive sleep apnea are caused mainly by repetitive apneas and hypopneas. An alternative factor contributing to disordered sleep may be the obesity, which is frequently associated with sleep apnea. The sleep disturbing effect of obesity was found previously in obese nonapneic subjects. The aim of this study was to evaluate the effect of obesity on sleep quality in sleep apnea patients in particular in patients under continuous positive airway pressure (CPAP) with successfully normalized respiration. We reviewed the archive data of 18 non-obese, 18 obese and 17 severely obese age and gender matched sleep apnea patients treated with CPAP. The polysomnographic parameters from the diagnostic night, from the second night under CPAP and from the follow up night (after three months of CPAP use) were compared. Before CPAP the apnea hypopnea index was worse in obese and in severely obese group and it normalised under CPAP in all groups. The severely obese group showed more light sleep and less REM sleep before CPAP and inversely - less light and more REM sleep in the second night under CPAP than the non-obese group. In the follow up, there was no differences in sleep profile between groups. This study indicates obesity does not affect the sleep independently of respiratory disorders. Before therapy it is associated with more severe sleep apnea and indirectly with worse sleep quality.
阻塞性睡眠呼吸暂停中的睡眠障碍主要是由反复的呼吸暂停和呼吸不足引起的。导致睡眠紊乱的另一个因素可能是肥胖，肥胖常与睡眠呼吸暂停有关。肥胖对非呼吸暂停肥胖受试者睡眠的干扰作用以前已经被发现。本研究的目的是评估肥胖对睡眠呼吸暂停患者睡眠质量的影响，特别是对接受持续气道正压通气（CPAP）治疗且呼吸正常化的患者的影响。我们回顾了 18 名非肥胖、18 名肥胖和 17 名严重肥胖的年龄和性别匹配的睡眠呼吸暂停患者的档案数据，这些患者均接受 CPAP 治疗。比较了诊断夜、CPAP 治疗第二夜和随访夜（CPAP 使用三个月后）的多导睡眠图参数。在 CPAP 治疗前，肥胖组和严重肥胖组的呼吸暂停低通气指数（apnea hypopnea index）更差，在所有组中均在 CPAP 治疗下正常化。在 CPAP 治疗前，严重肥胖组的浅睡眠时间较多，快速眼动（REM）睡眠时间较少，而在 CPAP 治疗的第二夜，其浅睡眠时间较少，REM 睡眠时间较多。在随访期间，各组之间的睡眠模式没有差异。本研究表明，肥胖症与呼吸障碍无关，不会独立影响睡眠。在治疗前，肥胖与更严重的睡眠呼吸暂停有关，并间接导致更差的睡眠质量。
