Goel Amrit K, Talwar Deepak, Jain Sushil K
Department of Respiratory, Sleep, Allergy, and Critical Care Medicine, Metro Centre for Respiratory Diseases, Metro Group of Hospitals, Noida, Uttar Pradesh, India.
Lung India. 2015 May-Jun;32(3):225-32. doi: 10.4103/0970-2113.156226.
The obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common chronic respiratory disease, characterized by repetitive complete or partial collapse of the upper airway during sleep. The clinical spectrum extends between stoppage of breathing, snoring, daytime somnolence, and fatigue, to serious cardiovascular disease, stroke, metabolic syndrome, increased morbidity, and mortality. We aim to evaluate the short-term use of nasal continuous positive airway pressure (nCPAP) therapy for the clinical profile and exercise capacity of patients with OSAHS.
Twenty patients diagnosed with moderate-to-severe OSAHS were enrolled in the study (study group - 15; clinically and PSG-matched control group - 5).
Each patient was clinically evaluated for sleep-related symptoms, and also assessed with spirometry, the six-minute walk test (6MWT), and a symptom-limited incremental cardiopulmonary exercise test (CPET). The study group patients were administered nCPAP therapy for eight hours each night for four weeks, while the control group patients were just observed. They were re-assessed after four weeks and the data were statistically analyzed between the two groups.
The study group patients showed a significant (P- < 0.05) improvement in the OSAHS symptoms-the Epworth sleepiness score, six-minute walk distance; duration of exercise, power output, peak oxygen uptake, anaerobic threshold, diastolic blood pressure, dyspnea, and fatigue-in comparison with the control group patients. The improvement in exercise capacity following nCPAP therapy was attributed to the relief of disabling the OSAHS symptoms and improved cardiovascular, ventilator, and musculoskeletal functions.
All OSAHS patients must be treated with nCPAP.
阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是一种常见的慢性呼吸系统疾病,其特征为睡眠期间上呼吸道反复出现完全或部分塌陷。临床症状范围从呼吸暂停、打鼾、日间嗜睡和疲劳,到严重的心血管疾病、中风、代谢综合征、发病率和死亡率增加。我们旨在评估短期使用鼻持续气道正压通气(nCPAP)治疗对OSAHS患者临床特征和运动能力的影响。
20例诊断为中重度OSAHS的患者纳入本研究(研究组15例;临床和多导睡眠图(PSG)匹配的对照组5例)。
对每位患者进行与睡眠相关症状的临床评估,并通过肺活量测定、六分钟步行试验(6MWT)和症状限制递增心肺运动试验(CPET)进行评估。研究组患者每晚接受8小时nCPAP治疗,持续4周,而对照组患者仅进行观察。4周后对他们进行重新评估,并对两组数据进行统计学分析。
与对照组患者相比,研究组患者的OSAHS症状——爱泼华嗜睡量表评分、六分钟步行距离、运动持续时间、功率输出、峰值摄氧量、无氧阈、舒张压、呼吸困难和疲劳——有显著改善(P<0.05)。nCPAP治疗后运动能力的改善归因于OSAHS症状的缓解以及心血管、通气和肌肉骨骼功能的改善。
所有OSAHS患者均须接受nCPAP治疗。