Zhang Cathy, Ramsay Michelle, Drakatos Panagis, Steier Joerg
Faculty of Life Sciences and Medicine, King's College London, London, UK.
Guy's and St Thomas' NHS Foundation Trust, Lane Fox Respiratory Unit/Sleep Disorders Centre, London, UK.
J Thorac Dis. 2018 Jan;10(Suppl 1):S153-S159. doi: 10.21037/jtd.2017.06.40.
Patients with neuromuscular disease (NMD) are at risk of developing sleep-disordered breathing (SDB) with hypercapnic respiratory failure. We hypothesised that a self-administered questionnaire (SiNQ-5 scores) may be useful to assess patients who are established on treatment for NMD with SDB.
Patients attending a tertiary referral centre filled in the SiNQ-5 (range 0-10 points, lower scores indicating fewer symptoms). The questionnaire contains five questions related to breathlessness, sleep and posture. Patients with NMD and treated SDB were compared to NMD without SDB, to sleep apnoea, chronic obstructive pulmonary disease (COPD) and heart failure (HF) patients' scores, as well as a group of patients without SDB. Results were compared using Kruskal-Wallis one-way analysis of variance, with Dunn/Bonferroni post-hoc tests if comparisons were found to be statistically significant.
A total of 265 (156 male) patients completed the assessment, 40 had NMD with treated SDB [SiNQ-5 score 3.4 (3.0) points], 11 had NMD without SDB [2.7 (2.9) points], 120 patients had obstructive sleep apnoea (OSA) [4.1 (2.6) points], 16 had COPD [3.9 (3.0) points] and 9 had HF [3.2 (2.8) points], 69 patients had other conditions with no evidence of SDB [3.0 (2.4) points; P=0.077]. Patients with NMD without SDB and those with SDB who were on treatment did not differ in their responses (P=0.417). Question #1 allowed discrimination between patients with NMD with SDB [0.8 (0.8) points] and other disorders without respiratory involvement [0.3 (0.6) points; P=0.024].
The SiNQ-5 scores in neuromuscular patients with SDB who are established on treatment and NMD patients without SDB, as well as in patients with other conditions leading to SDB are similar.
神经肌肉疾病(NMD)患者有发生伴高碳酸血症性呼吸衰竭的睡眠呼吸障碍(SDB)的风险。我们推测,一份自我管理问卷(SiNQ-5评分)可能有助于评估已确诊患有NMD并伴有SDB且正在接受治疗的患者。
在一家三级转诊中心就诊的患者填写SiNQ-5问卷(范围为0至10分,分数越低表明症状越少)。该问卷包含五个与呼吸急促、睡眠和姿势相关的问题。将患有NMD且已治疗SDB的患者与未患SDB的NMD患者、睡眠呼吸暂停患者、慢性阻塞性肺疾病(COPD)患者和心力衰竭(HF)患者的评分进行比较,同时与一组无SDB的患者进行比较。使用Kruskal-Wallis单因素方差分析比较结果,若发现比较具有统计学意义,则采用Dunn/Bonferroni事后检验。
共有265名(156名男性)患者完成了评估,40名患有NMD且已治疗SDB [SiNQ-5评分为3.4(3.0)分],11名患有NMD但无SDB [2.7(2.9)分],120名患者患有阻塞性睡眠呼吸暂停(OSA)[4.1(2.6)分],16名患有COPD [3.9(3.0)分],9名患有HF [3.2(2.8)分],69名患者患有其他疾病且无SDB证据[3.0(2.4)分;P = 0.077]。未患SDB的NMD患者和正在接受治疗的SDB患者的回答没有差异(P = 0.417)。问题1能够区分患有NMD且伴有SDB的患者[0.8(0.8)分]和无呼吸受累的其他疾病患者[0.3(0.6)分;P = 0.024]。
已确诊患有NMD并伴有SDB且正在接受治疗的患者、未患SDB的NMD患者以及患有其他导致SDB疾病的患者的SiNQ-5评分相似。