高危打鼾者日间两小时与夜间多导睡眠图的对比研究。

A comparative study of two-hour daytime and overnight polysomnography in high risk snorers.

作者信息

Mahakit Prasit

机构信息

Phramongkutklao Hospital, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2012 May;95 Suppl 5:S17-22.

PMID:22934440

Abstract

OBJECTIVE

To compare two-hour daytime polysomnography (DPSG) and overnight polysomnography (ONPSG) (as the gold standard) in screening for high risk snorers.

STUDY DESIGN

Descriptive study (diagnostic test).

SETTING

Snoring Clinic, Phramongkutklao Hospital.

MATERIAL AND METHOD

The present study was carried out among patients attending the Snoring clinic at Phramongkutklao hospital from September 2005 to February 2006 who had high risk of sleep apnea (pre-test) and scheduled for overnight PSG. Additionally, subjects were willing to take a two-hour daytime polysomnography. Both tests were performed less than two months apart. Each case was assessed using the Epworth sleepiness scale (ESS) > or = 8/24 and/or BMI > or = 27.5 kg/sqm as criteria to define as high risk snorer. After performing polysomnography, the subjects were categorized as high risk obstructive sleep apnea syndrome (OSAS, AHI > or = 20/hour) and low risk OSAS (AHI < 20/hour). Regarding snoring sound, subjects were divided into three groups: mild, moderate and severe.

RESULTS

Fifty subjects, 33 males and 17females, were enrolled in the present study. Two males were excluded due to a daytime PSG recording less than two hours. The mean age was 48.3 +/- 10.64 years (22-65), mean BMI was 27.69 +/- 3.95 kg/sqm (22.5-36.9) and ESS 10.56 +/- 2.25/24. The mean AI and AHI for daytime PSG vs. overnight PSG were 24.31 +/- 21.36, 28.30 +/- 21.44 vs. 22.39 +/- 20.43 and 25.30 +/- 20.91 respectively. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of daytime PSG compared with overnight PSG were 92%, 91.3%, 92% and 91.3% respectively. The agreement of snoring during day and night (K-value) was 0.716 +/- 0.1 (p = 0.03).

CONCLUSION

Sleep parameters (AI, AHI) for daytime PSG had high sensitivity, specificity, PPV and NPV compared with standard overnight PSG. These can be used as reliable screening tests for high risk snorers and also be used to assess the outcome of OSAS patients undergoing surgical intervention.

摘要

目的

比较两小时日间多导睡眠图（DPSG）和夜间多导睡眠图（ONPSG，作为金标准）在筛查高危打鼾者中的作用。

研究设计

描述性研究（诊断试验）。

研究地点

诗里蒙库贴皇家医院打鼾诊所。

材料与方法

本研究纳入了2005年9月至2006年2月期间在诗里蒙库贴皇家医院打鼾诊所就诊、有睡眠呼吸暂停高风险（预测试）且计划进行夜间多导睡眠图检查的患者。此外，受试者愿意接受两小时的日间多导睡眠图检查。两项检查的间隔时间均少于两个月。以爱泼华嗜睡量表（ESS）≥8/24和/或体重指数（BMI）≥27.5kg/m²作为定义高危打鼾者的标准对每个病例进行评估。在进行多导睡眠图检查后，将受试者分为高危阻塞性睡眠呼吸暂停综合征（OSAS，呼吸暂停低通气指数[AHI]≥20次/小时）和低危OSAS（AHI＜20次/小时）。关于打鼾声音，将受试者分为三组：轻度、中度和重度。

结果

本研究共纳入50名受试者，其中男性33名，女性17名。两名男性因日间多导睡眠图记录时间少于两小时而被排除。平均年龄为48.3±10.64岁（22 - 65岁），平均BMI为27.69±3.95kg/m²（22.5 - 36.9），ESS为10.56±2.25/24。日间多导睡眠图与夜间多导睡眠图的平均呼吸紊乱指数（AI）和AHI分别为24.31±21.36、28.30±21.44和22.39±20.43、25.30±20.91。与夜间多导睡眠图相比，日间多导睡眠图的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为92%、91.3%、92%和91.3%。日间和夜间打鼾的一致性（K值）为0.716±0.1（p = 0.03）。