美国睡眠医学学会（AASM）2012年推荐的呼吸浅慢标准增加了阻塞性睡眠呼吸暂停的发病率，但并未增加体位性阻塞性睡眠呼吸暂停的比例。
The AASM 2012 recommended hypopnea criteria increase the incidence of obstructive sleep apnea but not the proportion of positional obstructive sleep apnea.
作者信息
Duce Brett, Kulkas Antti, Langton Christian, Töyräs Juha, Hukins Craig
机构信息
Sleep Disorders Centre, Department of Respiratory & Sleep Medicine, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, Queensland, Australia; Faculty of Science and Engineering, Queensland University of Technology, Queensland, Australia.
Department of Clinical Neurophysiology, Seinäjoki Central Hospital, Seinäjoki, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
出版信息
Sleep Med. 2016 Oct;26:23-29. doi: 10.1016/j.sleep.2016.07.013. Epub 2016 Oct 18.
OBJECTIVE/BACKGROUND: This study compared the effects of using the 2007 and 2012 American Academy of Sleep Medicine (AASM) recommended hypopnea criteria on the proportion of positional obstructive sleep apnea (pOSA). The effect of modifying the minimum recording time in each sleeping position on the proportion of pOSA was also investigated.
PATIENTS/METHODS: 207 of 303 consecutive patients (91 of 207 were female) participated in polysomnography (PSG) for the suspicion of OSA met the inclusion criteria for this retrospective investigation. PSGs were scored for both the 2007 AASM recommended hypopnea criteria (AASM) and the 2012 AASM recommended hypopnea criteria (AASM). For each hypopnea criteria OSA patients were grouped as positional [either supine predominant OSA (spOSA) or supine independent OSA (siOSA)] or non-positional. Outcome measures such as SF-36, FOSQ, PVT, and DASS-21 were compared between groups.
RESULTS
The AASM increased the incidence of OSA compared to AASM (84% vs 49% respectively). AASM increased the number of patients with supine predominant OSA (spOSA) and supine independent OSA (siOSA) but did not change the proportion (spOSA: 61% AASM vs 61% AASM, siOSA: 32% AASM vs 36% AASM). OSA patients diagnosed by AASM had similar outcome measures to those diagnosed by the AASM criteria. The AASM increased the proportion of female OSA patients with spOSA and siOSA. A minimum recording time of 60 minutes in each position decreased the proportion of spOSA, but not siOSA patients when compared to a minimum time of 15 minutes.
CONCLUSIONS
This study demonstrates that, compared to AASM, AASM almost doubles the incidence of OSA but does not alter the proportion of OSA patients with pOSA. The proportion of female OSA patients with pOSA however, increases as a result of AASM. Furthermore, the use of different minimum recording times in each sleeping position can alter the proportion of spOSA.
目的/背景：本研究比较了采用2007年和2012年美国睡眠医学学会（AASM）推荐的呼吸暂停低通气标准对体位性阻塞性睡眠呼吸暂停（pOSA）比例的影响。还研究了改变每个睡眠体位的最短记录时间对pOSA比例的影响。
患者/方法：连续303例因疑似阻塞性睡眠呼吸暂停（OSA）而接受多导睡眠图（PSG）检查的患者中有207例（207例中的91例为女性）符合本回顾性研究的纳入标准。PSG根据2007年AASM推荐的呼吸暂停低通气标准（AASM）和2012年AASM推荐的呼吸暂停低通气标准（AASM）进行评分。对于每种呼吸暂停低通气标准，OSA患者被分为体位性（仰卧位为主的OSA（spOSA）或仰卧位独立的OSA（siOSA））或非体位性。比较了各组之间的SF-36、FOSQ、PVT和DASS-21等结果指标。
结果
与AASM相比，AASM增加了OSA的发病率（分别为84%和49%）。AASM增加了仰卧位为主的OSA（spOSA）和仰卧位独立的OSA（siOSA）患者的数量，但未改变比例（spOSA：AASM为61%，AASM为61%；siOSA：AASM为32%，AASM为36%）。根据AASM诊断的OSA患者与根据AASM标准诊断的患者有相似的结果指标。AASM增加了患有spOSA和siOSA的女性OSA患者比例。与最短时间15分钟相比，每个体位60分钟的最短记录时间降低了spOSA患者的比例，但未降低siOSA患者的比例。
结论
本研究表明，与AASM相比，AASM使OSA的发病率几乎增加了一倍，但未改变pOSA的OSA患者比例。然而，由于AASM，患有pOSA的女性OSA患者比例增加。此外，在每个睡眠体位使用不同的最短记录时间可以改变spOSA的比例。
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