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成年镰状细胞病患者的睡眠障碍

Sleep disorders in adult sickle cell patients.

作者信息

Sharma Sunil, Efird Jimmy T, Knupp Charles, Kadali Renuka, Liles Darla, Shiue Kristin, Boettger Peter, Quan Stuart F

机构信息

Pulmonary and Critical Care Medicine, Jefferson Sleep Disorders Center, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA.

East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, NC.

出版信息

J Clin Sleep Med. 2015 Mar 15;11(3):219-23. doi: 10.5664/jcsm.4530.

Abstract

STUDY OBJECTIVES

While sleep apnea has been studied in children with sickle cell disease (SCD), little is known about sleep disorders in adult sickle cell patients. The objective of this study was to evaluate sleep disordered breathing and its polysomnographic characteristics in adult patients with sickle cell disease.

METHODS

The analysis cohort included 32 consecutive adult SCD patients who underwent a comprehensive sleep evaluation and overnight polysomnography in an accredited sleep center after reporting symptoms suggesting disordered sleep or an Epworth Sleepiness Scale score ≥ 10. Epworth score, sleep parameters, comorbid conditions, and narcotic use were reviewed and compared in patients with and without sleep disordered breathing. SCD complication rates in the two groups also were compared.

RESULTS

In adult SCD patients who underwent overnight polysomnography, we report a high prevalence (44%) of sleep disordered breathing. Disease severity was mild to moderate (mean apnea-hypopnea index = 17/h (95% CI: 10-24/h). Concomitant sleep disorders, including insomnia complaints (57%) and delayed sleep-phase syndrome (57%), also were common in this population. In this limited cohort, we did not find increased SCD complications associated with sleep disordered breathing in adult patients with sickle cell disease.

CONCLUSIONS

A high burden of sleep disordered breathing and other sleep-related complaints were identified in the adult sickle cell population. Our results provide important information on this unique population.

摘要

研究目的

虽然已经对镰状细胞病(SCD)患儿的睡眠呼吸暂停进行了研究,但对于成年镰状细胞病患者的睡眠障碍却知之甚少。本研究的目的是评估成年镰状细胞病患者的睡眠呼吸障碍及其多导睡眠图特征。

方法

分析队列包括32例连续的成年SCD患者,这些患者在报告有睡眠障碍症状或爱泼沃斯思睡量表评分≥10后,在一家经认可的睡眠中心接受了全面的睡眠评估和夜间多导睡眠图检查。对有和没有睡眠呼吸障碍的患者的爱泼沃斯评分、睡眠参数、合并症和麻醉药物使用情况进行了回顾和比较。还比较了两组的SCD并发症发生率。

结果

在接受夜间多导睡眠图检查的成年SCD患者中,我们报告睡眠呼吸障碍的患病率很高(44%)。疾病严重程度为轻度至中度(平均呼吸暂停低通气指数=17次/小时(95%CI:10-24次/小时))。在这一人群中,包括失眠主诉(57%)和睡眠时相延迟综合征(57%)在内的伴随睡眠障碍也很常见。在这个有限的队列中,我们没有发现成年镰状细胞病患者的睡眠呼吸障碍与SCD并发症增加有关。

结论

在成年镰状细胞病患者中发现了高负担的睡眠呼吸障碍和其他与睡眠相关的主诉。我们的结果为这一独特人群提供了重要信息。

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