Muraja-Murro A, Nurkkala J, Tiihonen P, Hukkanen T, Tuomilehto H, Kokkarinen J, Mervaala E, Töyräs J
Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland.
J Med Eng Technol. 2012 Nov;36(8):393-8. doi: 10.3109/03091902.2012.712201. Epub 2012 Sep 7.
Obstructive sleep apnea (OSA) is commonly diagnosed based on the apnea-hypopnea index (AHI). Presently, novel indices were introduced for sleep apnea severity: total duration of sleep apnea and hypopnea events (TAHD%) and a combined index including duration and severity of the events (TAHD% × average desaturation). Two hundred and sixty-seven subjects were divided based on their AHI into four categories (normal, mild, moderate, severe OSA). In the most severe cases TAHD% exceeded 70% of the recorded time. This is important as excessive TAHD% may increase mortality and cerebro-vascular complications. Moreover, simultaneous increase in duration and frequency of apnea and hypopnea events leads to a paradoxical situation where AHI cannot increase along severity of the disease. Importantly, the combined index including duration and severity of the events showed significant variation between patients with similar apnea-hypopnea indices. To conclude, the present results suggest that the novel parameters could give supplementary information to AHI when diagnosing the severity of OSA.
阻塞性睡眠呼吸暂停(OSA)通常根据呼吸暂停低通气指数(AHI)进行诊断。目前,引入了新的指标来评估睡眠呼吸暂停的严重程度:睡眠呼吸暂停和低通气事件的总时长(TAHD%)以及一个包括事件时长和严重程度的综合指标(TAHD%×平均血氧饱和度下降)。267名受试者根据其AHI被分为四类(正常、轻度、中度、重度OSA)。在最严重的病例中,TAHD%超过了记录时间的70%。这很重要,因为过高的TAHD%可能会增加死亡率和脑血管并发症。此外,呼吸暂停和低通气事件的时长和频率同时增加会导致一种矛盾的情况,即AHI不会随着疾病严重程度的增加而升高。重要的是,包括事件时长和严重程度的综合指标在具有相似呼吸暂停低通气指数的患者之间显示出显著差异。总之,目前的结果表明,在诊断OSA严重程度时,这些新参数可以为AHI提供补充信息。