Ponsaing Laura B, Iversen Helle K, Jennum Poul
Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Nordre Ringvej 57, 2600, Glostrup, Denmark.
Center for Healthy Aging, Copenhagen University, Copenhagen, Denmark.
Sleep Breath. 2016 Mar;20(1):219-26. doi: 10.1007/s11325-015-1210-2. Epub 2015 Jun 13.
We aimed to evaluate the three hypopnea criteria, A and B from 2007 and the revised from 2012, proposed by the American Academy of Sleep Medicine (AASM) for scoring sleep-related breathing disorders (SRBDs) in patients with acute stroke or transient ischemic attack (TIA).
Polysomnographies (PSGs) in patients with TIA or stroke were scored according to the A-, B-, and 2012-hypopnea criteria.
Sixty-three PSGs were eligible for hypopnea scoring. There was no difference in the number of patients diagnosed with the B- and 2012-criteria. Therefore, they are mentioned as one. Forty-seven patients (75 %) were diagnosed with SRBD using the A-criteria versus 57 patients (90 %) using the B/2012-criteria (p < 0.0016). In 30 cases, a change from A- to B/2012-criteria resulted in a change in diagnosis. Ten cases of "no SRBD" changed to mild/moderate/severe SRBD. An apnea hypopnea index (AHI) >15 is a typical indication of treatment. With the B/2012-criteria, we found an additional indication of treatment in 18 patients, compared to when the A-criteria were applied (p < 0.0001). Two of these patients were labeled as no SRBD with the A-criteria.
The difference is significant between the AHIs achieved by the A- and the B-/2012-hypopnea criteria, with much lower AHIs achieved with the A-criteria. As SRBD treatment lessens the risk of complications, correct identification of SRBD patients is of the utmost importance.
我们旨在评估美国睡眠医学会（AASM）提出的三种低通气标准，即2007年的A标准和B标准以及2012年修订的标准，用于对急性卒中或短暂性脑缺血发作（TIA）患者的睡眠相关呼吸障碍（SRBD）进行评分。
根据A标准、B标准和2012年低通气标准，对TIA或卒中患者的多导睡眠图（PSG）进行评分。
63份PSG符合低通气评分标准。使用B标准和2012年标准诊断出的患者数量没有差异。因此，将它们合并提及。采用A标准诊断出47例（75%）SRBD患者，而采用B/2012标准诊断出57例（90%）（p < 0.0016）。在30例患者中，从A标准改为B/2012标准导致诊断改变。10例“无SRBD”患者改为轻度/中度/重度SRBD。呼吸暂停低通气指数（AHI）>15是治疗的典型指征。与应用A标准相比，采用B/2012标准时，我们发现另外有18例患者有治疗指征（p < 0.0001）。其中2例患者按照A标准被判定为无SRBD。
A标准与B/2012低通气标准所获得的AHI之间存在显著差异，A标准获得的AHI要低得多。由于SRBD治疗可降低并发症风险，正确识别SRBD患者至关重要。
