Clinic for Cardiac and Pulmonary Rehabilitation, Rosenquelle, Aachen, Germany
MediClin Rehabilitation Centre of Spreewald, Burg/Spreewald, Germany.
Eur J Prev Cardiol. 2015 Jul;22(7):820-30. doi: 10.1177/2047487314537916. Epub 2014 May 30.
To determine the prevalence of, and the risk factors for, sleep apnoea in cardiac rehabilitation (CR) facilities in Germany.
1152 patients presenting for CR were screened for sleep-disordered breathing with 2-channel polygraphy (ApneaLink™; ResMed). Parameters recorded included the apnoea-hypopnoea index (AHI), number of desaturations per hour of recording (ODI), mean and minimum nocturnal oxygen saturation and number of snoring episodes. Patients rated subjective sleep quality on a scale from 1 (poor) to 10 (best) and completed the Epworth Sleepiness Scale (ESS).
Clinically significant sleep apnoea (AHI ≥15/h) was documented in 33% of patients. Mean AHI was 14 ± 16/h (range 0-106/h). Sleep apnoea was defined as being of moderate severity in 18% of patients (AHI ≥15-29/h) and severe in 15% (AHI ≥30/h). There were small, but statistically significant, differences in ESS score and subjective sleep quality between patients with and without sleep apnoea. Logistic regression model analysis identified the following as risk factors for sleep apnoea in CR patients: age (per 10 years) (odds ratio (OR) 1.51; p<0.001), body mass index (per 5 units) (OR 1.31; p=0.001), male gender (OR 2.19; p<0.001), type 2 diabetes mellitus (OR 1.45; p=0.040), haemoglobin level (OR 0.91; p=0.012) and witnessed apnoeas (OR 1.99; p<0.001).
The findings of this study indicate that more than one-third of patients undergoing cardiac rehabilitation in Germany have sleep apnoea, with one-third having moderate-to-severe SDB that requires further evaluation or intervention. Inclusion of sleep apnoea screening as part of cardiac rehabilitation appears to be appropriate.
确定德国心脏康复（CR）机构中睡眠呼吸暂停的患病率和危险因素。
1152 名接受 CR 的患者接受了 2 通道多导睡眠图（ApneaLink™；ResMed）筛查睡眠呼吸障碍。记录的参数包括呼吸暂停低通气指数（AHI）、每小时记录的脱氧饱和度次数（ODI）、平均和最低夜间血氧饱和度以及打鼾发作次数。患者根据睡眠质量从 1（差）到 10（好）进行主观评分，并完成 Epworth 嗜睡量表（ESS）。
33%的患者被诊断为临床显著的睡眠呼吸暂停（AHI≥15/h）。平均 AHI 为 14±16/h（范围 0-106/h）。18%的患者（AHI≥15-29/h）和 15%的患者（AHI≥30/h）被定义为中度睡眠呼吸暂停。ESS 评分和主观睡眠质量在有和无睡眠呼吸暂停的患者之间存在微小但有统计学意义的差异。Logistic 回归模型分析确定了以下因素是 CR 患者睡眠呼吸暂停的危险因素：年龄（每 10 岁）（优势比（OR）1.51；p<0.001）、体重指数（每 5 个单位）（OR 1.31；p=0.001）、男性（OR 2.19；p<0.001）、2 型糖尿病（OR 1.45；p=0.040）、血红蛋白水平（OR 0.91；p=0.012）和目击性呼吸暂停（OR 1.99；p<0.001）。
这项研究的结果表明，德国接受心脏康复的患者中有超过三分之一患有睡眠呼吸暂停，其中三分之一患有中重度 SDB，需要进一步评估或干预。将睡眠呼吸暂停筛查纳入心脏康复似乎是合适的。
