Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Sleep Breath. 2019 Jun;23(2):559-565. doi: 10.1007/s11325-018-1745-0. Epub 2018 Oct 20.
Although mixed sleep apnea (MSA) is one of the three types of sleep apnea, it is not considered a separate disease entity. It is generally seen as a part of obstructive sleep apnea-hypopnea syndrome (OSAHS), but its implications are often ignored. In this study, we examined its features and the potential impact on OSAHS patients.
Subjects diagnosed with OSAHS by polysomnography (PSG) were enrolled. All participants underwent physical checkups and tests of blood biochemistry. They were anthropometrically, clinically, and polysomnographically studied.
MSA events were common in patients with severe OSAHS patients. There were significant differences between the pure OSAHS group and its mixed counterpart in apnea-hypopnea indices during REM (AHI) and non-REM (AHI) and in percentages of N2 or N3 sleep. Logistic regression analysis showed that, after adjustment of other parameters, patients with MSA events were mostly male, had higher body mass index (BMI), higher scores on Epworth Sleepiness Scales (ESS), higher triglyceride (TG) levels, and higher apnea-hypopnea index (AHI). The combined predictive probability of the aforementioned variables was 0.766 (95% CI = 0.725~0.806; sensitivity 61.6%, specificity 82.1%).
Our study suggested that MSA was related to the stability of the ventilatory control in OSAHS patients. MSA events occur more frequently in patients with severe OSAHS, and male gender, obesity, daytime sleepiness, and elevated TG levels were risk factors for the mixed OSAHS.
尽管混合性睡眠呼吸暂停（MSA）是睡眠呼吸暂停的三种类型之一，但它并不被认为是一种独立的疾病实体。它通常被视为阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的一部分，但它的影响往往被忽视。在本研究中，我们研究了它的特征及其对 OSAHS 患者的潜在影响。
我们纳入了经多导睡眠图（PSG）诊断为 OSAHS 的患者。所有参与者均接受了体格检查和血液生化检查。对他们进行了人体测量学、临床和多导睡眠图研究。
MSA 事件在重度 OSAHS 患者中很常见。在 REM（AHI）和非 REM（AHI）期间的呼吸暂停-低通气指数（AHI）以及 N2 或 N3 睡眠的百分比方面，单纯 OSAHS 组和混合组之间存在显著差异。逻辑回归分析显示，在调整其他参数后，MSA 事件患者主要为男性，体重指数（BMI）较高，Epworth 嗜睡量表（ESS）评分较高，甘油三酯（TG）水平较高，呼吸暂停-低通气指数（AHI）较高。上述变量的联合预测概率为 0.766（95%CI=0.725~0.806；灵敏度 61.6%，特异性 82.1%）。
我们的研究表明，MSA 与 OSAHS 患者通气控制的稳定性有关。MSA 事件在重度 OSAHS 患者中更为常见，男性、肥胖、白天嗜睡和 TG 水平升高是混合性 OSAHS 的危险因素。
