Castellanos-Ramírez Julio Cesar, Ruíz Alvaro J, Hidalgo-Martínez Patricia, Otero-Mendoza Liliana
. Hospital Universitario San Ignacio, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.
. Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.
J Bras Pneumol. 2018 Jan-Feb;44(1):65-68. doi: 10.1590/S1806-37562016000000078.
Sleep studies conducted at an altitude that is different from the home altitude can yield misleading results regarding the severity of obstructive sleep apnea (OSA). The objective of the present study was to determine the sleep characteristics of a patient undergoing polysomnography (PSG) in three Colombian cities at different altitudes (Bogotá, at 2,640 m above sea level [ASL]; Bucaramanga, at 959 m ASL; and Santa Marta, at 15 m ASL). The patient was an obese man with diabetes and suspected OSA. All PSG recordings were scored and interpreted in accordance with American Academy of Sleep Medicine criteria. In Bogotá, PSG revealed moderate OSA (an apnea-hypopnea index [AHI] of 21 events/h); in Bucaramanga, PSG revealed increased upper airway resistance (an AHI of 2 events/h); in Santa Marta, PSG revealed mild OSA (an AHI of 7 events/h). The reduction in the AHI was predominantly a reduction in hypopneas and obstructive apneas. The respiratory events were shorter in duration in the city at an intermediate altitude. Given that the AHI varied widely across cities, we can assume that the patient is normal or has moderate OSA depending on the city where he is. Central apneas were found to have no influence on the AHI.
在与居住海拔不同的高度进行睡眠研究,可能会在阻塞性睡眠呼吸暂停(OSA)严重程度方面产生误导性结果。本研究的目的是确定一名接受多导睡眠图(PSG)检查的患者在哥伦比亚三个不同海拔城市(波哥大,海拔2640米;布卡拉曼加,海拔959米;圣玛尔塔,海拔15米)的睡眠特征。该患者是一名患有糖尿病且疑似OSA的肥胖男性。所有PSG记录均按照美国睡眠医学学会标准进行评分和解读。在波哥大,PSG显示为中度OSA(呼吸暂停低通气指数[AHI]为21次/小时);在布卡拉曼加,PSG显示上气道阻力增加(AHI为2次/小时);在圣玛尔塔,PSG显示为轻度OSA(AHI为7次/小时)。AHI的降低主要是低通气和阻塞性呼吸暂停的减少。在中等海拔城市,呼吸事件的持续时间较短。鉴于AHI在不同城市差异很大,我们可以假设根据患者所在城市,他要么正常,要么患有中度OSA。发现中枢性呼吸暂停对AHI没有影响。