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夜间盗汗——阻塞性睡眠呼吸暂停的常见症状:冰岛睡眠呼吸暂停队列研究。

Nocturnal sweating--a common symptom of obstructive sleep apnoea: the Icelandic sleep apnoea cohort.

机构信息

Department of Respiratory Medicine and Sleep, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.

出版信息

BMJ Open. 2013 May 14;3(5):e002795. doi: 10.1136/bmjopen-2013-002795.

Abstract

OBJECTIVES

To estimate the prevalence and characteristics of frequent nocturnal sweating in obstructive sleep apnoea (OSA) patients compared with the general population and evaluate the possible changes with positive airway pressure (PAP) treatment. Nocturnal sweating can be very bothersome to the patient and bed partner.

DESIGN

Case-control and longitudinal cohort study.

SETTING

Landspitali-The National University Hospital, Iceland.

PARTICIPANTS

The Icelandic Sleep Apnea Cohort consisted of 822 untreated patients with OSA, referred for treatment with PAP. Of these, 700 patients were also assessed at a 2-year follow-up. The control group consisted of 703 randomly selected subjects from the general population.

INTERVENTION

PAP therapy in the OSA cohort.

MAIN OUTCOME MEASURES

Subjective reporting of nocturnal sweating on a frequency scale of 1-5: (1) never or very seldom, (2) less than once a week, (3) once to twice a week, (4) 3-5 times a week and (5) every night or almost every night. Full PAP treatment was defined objectively as the use for ≥4 h/day and ≥5 days/week.

RESULTS

Frequent nocturnal sweating (≥3× a week) was reported by 30.6% of male and 33.3% of female OSA patients compared with 9.3% of men and 12.4% of women in the general population (p<0.001). This difference remained significant after adjustment for demographic factors. Nocturnal sweating was related to younger age, cardiovascular disease, hypertension, sleepiness and insomnia symptoms. The prevalence of frequent nocturnal sweating decreased with full PAP treatment (from 33.2% to 11.5%, p<0.003 compared with the change in non-users).

CONCLUSIONS

The prevalence of frequent nocturnal sweating was threefold higher in untreated OSA patients than in the general population and decreased to general population levels with successful PAP therapy. Practitioners should consider the possibility of OSA in their patients who complain of nocturnal sweating.

摘要

目的

评估阻塞性睡眠呼吸暂停(OSA)患者与普通人群相比频繁夜间出汗的患病率和特征,并评估正压通气(PAP)治疗可能带来的变化。夜间出汗会给患者及其床伴带来很大困扰。

设计

病例对照和纵向队列研究。

地点

冰岛 Landspitali- 国立大学医院。

参与者

冰岛睡眠呼吸暂停队列包括 822 名未经治疗的 OSA 患者,他们被转诊接受 PAP 治疗。其中 700 名患者还在 2 年随访时接受了评估。对照组由普通人群中随机选择的 703 名受试者组成。

干预

OSA 队列中的 PAP 治疗。

主要观察指标

夜间出汗频率的主观报告,频率范围为 1-5:(1)从不或很少,(2)每周少于一次,(3)每周一至两次,(4)每周三至五次,(5)每晚或几乎每晚。全剂量 PAP 治疗被定义为每天使用≥4 小时且每周使用≥5 天。

结果

30.6%的男性和 33.3%的女性 OSA 患者报告频繁夜间出汗(每周≥3 次),而普通人群中男性和女性的这一比例分别为 9.3%和 12.4%(p<0.001)。调整人口统计学因素后,这种差异仍然显著。夜间出汗与年龄较小、心血管疾病、高血压、嗜睡和失眠症状有关。随着全剂量 PAP 治疗的进行(从不使用者的 33.2%降至 11.5%,p<0.003),频繁夜间出汗的患病率下降。

结论

未经治疗的 OSA 患者频繁夜间出汗的患病率是普通人群的三倍,成功的 PAP 治疗可使这一患病率降至普通人群水平。医生在遇到抱怨夜间出汗的患者时,应考虑 OSA 的可能性。

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