Donovan Lucas M, Kapur Vishesh K
Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA.
Sleep. 2016 Jul 1;39(7):1353-9. doi: 10.5665/sleep.5962.
Determine the prevalence of central sleep apnea (CSA) in a large community-based cohort using current definitions and contrast the clinical characteristics of subjects with CSA to those with obstructive sleep apnea (OSA) and no sleep apnea.
A cross sectional analysis of baseline data from 5,804 participants of the Sleep Heart Health study was performed. Subjects meeting contemporary diagnostic criteria for CSA and Cheyne Stokes respiration (CSR) were compared to those without sleep apnea and those with OSA. Demographic data, medical comorbidities, medication use, and sleep related symptoms were compared between the groups.
The prevalences of CSA and Cheyne Stokes respiration (CSR) in this sample were 0.9 (95% confidence intervals [CI]: 0.7-1.2)% and 0.4 (95% CI: 0.3-0.6)%, respectively. Individuals with CSA were older, had lower body mass indexes (BMI), lower Epworth Sleepiness Scale scores, and were more likely to be male than individuals with obstructive sleep apnea OSA. Among those with self-reported heart failure (HF), OSA was much more common at 55.1% (95% CI: 45.6-64.6) than CSA 4.1% (95% CI: 0.3-7.9).
This is the largest community-based study of the prevalence and characteristics of CSA to date and demonstrates a prevalence of CSA that is intermediate to those previously noted. Contrary to prior data from clinic based samples, individuals with heart failure were much more likely to have OSA than CSA.
使用当前定义确定一个大型社区队列中中枢性睡眠呼吸暂停（CSA）的患病率，并对比CSA患者与阻塞性睡眠呼吸暂停（OSA）患者及无睡眠呼吸暂停患者的临床特征。
对睡眠心脏健康研究中5804名参与者的基线数据进行横断面分析。将符合CSA和陈-施呼吸（CSR）当代诊断标准的受试者与无睡眠呼吸暂停的受试者以及OSA患者进行比较。比较各组之间的人口统计学数据、合并症、药物使用情况以及与睡眠相关的症状。
该样本中CSA和陈-施呼吸（CSR）的患病率分别为0.9%（95%置信区间[CI]：0.7 - 1.2%）和0.4%（95%CI：0.3 - 0.6%）。与阻塞性睡眠呼吸暂停（OSA）患者相比，CSA患者年龄更大，体重指数（BMI）更低，爱泼华嗜睡量表得分更低，且男性比例更高。在自我报告有心力衰竭（HF）的患者中，OSA更为常见，患病率为55.1%（95%CI：45.6 - 64.6%），而CSA为4.1%（95%CI：0.3 - 7.9%）。
这是迄今为止关于CSA患病率和特征的最大规模社区研究，显示CSA患病率处于先前报道的中间水平。与先前基于临床样本的数据相反，心力衰竭患者患OSA的可能性远高于CSA。
