[睡眠体位、睡眠阶段与阻塞性睡眠呼吸暂停低通气综合征严重程度之间的关系研究]

Chen Xi, Sun Yumei, Sun Jianjun

Department of Otolaryngology-Head and Neck Surgery, Navy General Hospital, Beijing, 100048, China.

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Sep;26(17):774-6.

OBJECTIVE

To study the clinical characteristics and relationship between sleep body posture, sleep phase and occurrence in patients with various degree of obstructive sleep apnea-hypopnea syndrome (OSAHS).

METHOD

Polysomnography recordings of 100 adults with OSAHS were divided into 3 groups according to AHI: mild with apnea-hypopnea indices (5 < or = AHI < or = 15), moderate (15 < AHI < or = 30) and severe (30 < AHI). The polysomnography data and clinical characteristics were compared between each groups. REM sleep-related OSAHS was defined as REM AHI/NREM AHI > or = 2. Positional OSAHS was defined as supine AHI/non-supine AHI > or = 2.

RESULT

90.91% (20/22) patients with mild and 82.35% (14/17) patients with moderate OSAHS were position dependent, 40.91% (9/22) patients with mild and 23.53% (4/17) patients with moderate OSAHS were REM sleep-related OSAHS. The percentage of REM sleep-related OSAHS and position dependent OSAHS were significantly higher in mild and moderate groups compared with in severe group (P < 0.05, respectively). In both mild and moderate groups, the supine AHI was significantly correlated with AHI (r = 0.491, 0.771, P < 0.05, respectively). In severe groups, the non-supine AHI was significantly correlated with AHI and Lowest oxygen saturation (LSaO2) (r = -0.424, 0.527,P < 0.01, respectively), NREM AHI was significantly correlated with LSaO2 (r = 0.470, P < 0.01).

CONCLUSION

Body position play significant effects in mild and moderate but not severe OSAHS. Patients with severe OSAHS are less likely to spend time in the supine position and REM compared with patients with mild and moderate OSAHS.

目的

研究不同程度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的临床特征以及睡眠体位、睡眠阶段与发病之间的关系。

方法

对100例成年OSAHS患者的多导睡眠图记录根据呼吸暂停低通气指数（AHI）分为3组：轻度（呼吸暂停低通气指数5≤AHI≤15）、中度（15＜AHI≤30）和重度（30＜AHI）。比较各组之间的多导睡眠图数据和临床特征。快速眼动（REM）睡眠相关的OSAHS定义为REM AHI/非快速眼动（NREM）AHI≥2。体位性OSAHS定义为仰卧位AHI/非仰卧位AHI≥2。

结果

轻度OSAHS患者中90.91%（20/22）、中度OSAHS患者中82.35%（14/17）存在体位相关性，轻度OSAHS患者中40.91%（9/22）、中度OSAHS患者中23.53%为REM睡眠相关的OSAHS。轻度和中度组中REM睡眠相关的OSAHS和体位相关性OSAHS的百分比显著高于重度组（P分别＜0.05）。在轻度和中度组中，仰卧位AHI均与AHI显著相关（r分别为0.491、0.771，P均＜0.05）。在重度组中，非仰卧位AHI与AHI和最低血氧饱和度（LSaO2）显著相关（r分别为-0.424、0.527，P均＜0.01），NREM AHI与LSaO2显著相关（r = 0.470，P＜0.01）。