Koo Soo Kweon, Ahn Gun Young, Choi Jang Won, Kim Young Jun, Jung Sung Hoon, Moon Ji Seung, Lee Young Il
Busan Saint Mary's Hospital, Department of Otorhinolaryngology, Busan, South Korea.
Ulsan Hana ENT Hospital, Ulsan, South Korea.
Braz J Otorhinolaryngol. 2017 May-Jun;83(3):285-291. doi: 10.1016/j.bjorl.2016.03.011. Epub 2016 Apr 25.
The key to successful treatment of OSAS is to individually tailor such treatment. Thus, it is very important to determine the severity of OSAS, its pattern, and the extent of collapse, by gender, age, and BMI.
The objective of the study was to understand the characteristics of obstructive sleep apnea in postmenopausal women by comparing postmenopausal and premenopausal subjects, and men, using DISE. We hope that our work will help the medical community to consult on, diagnose, and treat OSAS more effectively.
A total of 273 patients (195 males and 78 females) diagnosed with OSAS were enrolled. Female patients were divided into pre-menopausal (n=41) and post-menopausal patients (n=37). The group of post-menopausal female patients was matched with a group of male patients with similar age and body mass index (BMI). DISE findings were compared between pre-menopausal female patients and post-menopausal female patients, and also between post-menopausal female patients and male patients matched for age and BMI.
Upon PSG examination, post-menopausal patients (who had a significantly higher BMI than did pre-menopausal patients; 25.6kg/m vs. 23.5kg/m; p=0.019) tended to have a higher AHI and a lower lowest SaO, but the differences did not attain statistical significance. With DISE analysis, post-menopausal female patients showed higher values in all obstruction sites, with significantly higher value in lateral diameter of retropalatal (1.49 vs. 0.90; p=0.001) and retrolingual levels (1.14 vs. 0.61; p=0.003) compared to pre-menopausal females patients. Post-menopausal female patients showed significantly more retrolingual collapse (antero-posterior, AP, p≤0.0001, and lateral diameter, p=0.042) in the lower BMI group (BMI<25) and more concentric retropalatal collapse (lateral diameter, p=0.017 and tonsillar obstruction, p=0.003) in higher BMI group (BMI≥25) than BMI and age matched male patients.
Post-menopausal female patients showed a different pattern of airway obstruction compared to pre-menopausal female patients and male patients matched for age and BMI based on DISE findings.
成功治疗阻塞性睡眠呼吸暂停综合征（OSAS）的关键在于进行个体化治疗。因此，根据性别、年龄和体重指数（BMI）来确定OSAS的严重程度、模式及塌陷程度非常重要。
本研究的目的是通过使用动态喉镜检查（DISE）比较绝经后女性与绝经前女性及男性，以了解绝经后女性阻塞性睡眠呼吸暂停的特征。我们希望我们的工作将有助于医学界更有效地进行OSAS的咨询、诊断和治疗。
共纳入273例诊断为OSAS的患者（195例男性和78例女性）。女性患者分为绝经前（n = 41）和绝经后患者（n = 37）。将绝经后女性患者组与年龄和体重指数（BMI）相似的男性患者组进行匹配。比较绝经前女性患者与绝经后女性患者之间以及绝经后女性患者与年龄和BMI匹配的男性患者之间的DISE结果。
多导睡眠图（PSG）检查显示，绝经后患者（其BMI显著高于绝经前患者；25.6kg/m²对23.5kg/m²；p = 0.019）的呼吸暂停低通气指数（AHI）往往较高，最低血氧饱和度（SaO₂）较低，但差异无统计学意义。通过DISE分析，绝经后女性患者在所有阻塞部位的值均较高，与绝经前女性患者相比，软腭后水平（1.49对0.90；p = 0.001）和舌后水平（1.14对0.61；p = 0.003）的直径显著更高。在较低BMI组（BMI < 25）中，绝经后女性患者的舌后塌陷（前后径，AP，p≤0.0001，和侧径，p = 0.042）明显更多，在较高BMI组（BMI≥25）中，与年龄和BMI匹配的男性患者相比，软腭后同心塌陷（侧径，p = 0.017和扁桃体阻塞，p = 0.003）更多。
根据DISE结果，绝经后女性患者与绝经前女性患者以及年龄和BMI匹配的男性患者相比，气道阻塞模式不同。
