Faria Júnior Newton Santos, Urbano Jessica Julioti, Santos Israel Reis, Silva Anderson Soares, Perez Eduardo Araújo, Souza Ângela Honda, Nascimento Oliver Augusto, Jardim José Roberto, Insalaco Giuseppe, Oliveira Luis Vicente Franco, Stirbulov Roberto
Master's degree and PhD Program in Surgery Research, Santa Casa de Sao Paulo School of Medical Sciences, (FCMSCSP), Sao Paulo (SP), Brazil.
Rehabilitation Sciences Master's degree and PhD Program, Nove de Julho University (UNINOVE), Sao Paulo (SP), Brazil.
PLoS One. 2017 Oct 3;12(10):e0185413. doi: 10.1371/journal.pone.0185413. eCollection 2017.
The relationship between sleep disorders and bronchiectasis has not been well described. We hypothesize that, due to the irreversible dilatation of the bronchi, the presence of secretions, and airflow obstruction, patients with non-cystic fibrosis bronchiectasis may be predisposed to hypoxemia during sleep, or to symptoms that may lead to arousal. A cross-sectional observational study was performed involving 49 patients with a clinical diagnosis of non-cystic fibrosis bronchiectasis (NCFB). All patients underwent clinical evaluation, spirometry, and polysomnography, and were evaluated for the presence of excessive daytime sleepiness (EDS) and risk of obstructive sleep apnea (OSA). The mean age of the participants was 50.3 ± 13.6 years; 51.1% of patients were male and had a mean body mass index of 23.8 ± 3.4 kg/m2. The mean total sleep time (TST) was 325.15 ± 64.22 min with a slight reduction in sleep efficiency (84.01 ± 29.2%). Regarding sleep stages, stage 1 sleep and REM sleep were abnormal. OSA was present in 40.82% of the patients. The mean arousal index was 5.6 ± 2.9/h and snoring was observed in 71.43% of the patients. The oxygen desaturation index (ODI) was 14.35 ± 15.36/h, mean minimum oxygen saturation (SpO2 nadir) was 83.29 ± 7.99%, and mean TST with an SpO2 less than 90% was 30.21 ± 60.48 min. EDS was exhibited by 53.06% of the patients and 55.1% were at high risk of developing OSA. The patients infected by Pseudomonas aeruginosa had higher apnea-hypopnea indices, ODI, and TST with SpO2 < 90%, and lower values of SpO2 nadir. Adult patients with clinically stable NCFB, especially those infected by Pseudomonas aeruginosa, display EDS and a high prevalence of OSA, associated with considerable oxygen desaturation during sleep.
睡眠障碍与支气管扩张之间的关系尚未得到充分描述。我们推测，由于支气管的不可逆扩张、分泌物的存在以及气流阻塞，非囊性纤维化支气管扩张患者在睡眠期间可能易发生低氧血症，或出现可能导致觉醒的症状。我们进行了一项横断面观察性研究，纳入了49例临床诊断为非囊性纤维化支气管扩张（NCFB）的患者。所有患者均接受了临床评估、肺功能测定和多导睡眠图检查，并评估了日间过度嗜睡（EDS）的存在情况和阻塞性睡眠呼吸暂停（OSA）的风险。参与者的平均年龄为50.3±13.6岁；51.1%的患者为男性，平均体重指数为23.8±3.4kg/m²。平均总睡眠时间（TST）为325.15±64.22分钟，睡眠效率略有降低（84.01±29.2%）。关于睡眠阶段，1期睡眠和快速眼动（REM）睡眠异常。40.82%的患者存在OSA。平均觉醒指数为5.6±2.9次/小时，71.43%的患者有打鼾现象。氧去饱和指数（ODI）为14.35±15.36次/小时，平均最低氧饱和度（SpO2最低点）为83.29±7.99%，SpO2低于90%的平均TST为30.21±60.48分钟。53.06%的患者表现出EDS，55.1%的患者有发生OSA的高风险。感染铜绿假单胞菌的患者呼吸暂停低通气指数、ODI以及SpO2<90%时的TST更高，而SpO2最低点的值更低。临床稳定的成年NCFB患者，尤其是那些感染铜绿假单胞菌的患者，表现出EDS和OSA的高患病率，且睡眠期间存在明显的氧去饱和。
