Shrestha Binav, Mukhtar Osama, Kandel Saroj, Bhattrai Bikash, Dattar Parveen, Amgai Birendra, Mandal Amrendra, Alhafidh Oday, Thapa Shivani, Khalid Mazin, Gayam Vijay, Ting Brandon, Enriquez Danilo A, Quist Joseph, Schmidt Marie Frances
Department of Internal Medicine, Interfaith Medical Centre, Brooklyn, NY, USA.
Department of Pulmonary Medicine, Interfaith Medical Centre, Brooklyn, NY, USA.
J Community Hosp Intern Med Perspect. 2019 Apr 12;9(2):108-112. doi: 10.1080/20009666.2019.1595951. eCollection 2019 Apr.
: To evaluate influence of asthma on polysomnographic variables of patients with obstructive sleep apnea (OSA).: A longitudinal retrospective study using data collected from the Sleep Heart Health Study (SHHS).: All 2822 patients included had OSA, 2599 were non-asthmatic whereas 223 were asthmatics. Average BMI for non-asthmatics was 28.8 kg/m whereas asthmatics had 29.5 kg/m. Median pack-years of smoking was 1.42 vs. 1.98 in non-asthmatic and asthmatic groups, respectively. Sex distribution, age (in years), BMI, FEV, FVC, AHI ≥ 4% (all apneas, hypopneas with ≥4% oxygen desaturation or arousal per hour of sleep), RDI ≥ 3% (overall respiratory distribution index at ≥3% oxygen desaturation or arousal), sleep latency, percentage of sleep time in apnea/hypopnea and Epworth sleep scale score were all statistically significant. Non-asthmatics had greater AHI (12.63/hr) compared to asthmatics (11.34/hour), = 0.0015. RDI in non-asthmatics and asthmatics was (23.07 vs 20.53; = 0.009). Sleep latency was found to be longer in asthmatics 19.8 minutes vs. 16 minutes ( = 0.008). Epworth sleepiness scale score was high in asthmatics (9 vs. 8, = 0.002).: OSA was found more severe in non-asthmatic subgroup, but asthmatics had statistically significant higher Epworth sleepiness scale score and sleep latency. Clinicians should be vigilant and keep low threshold to rule out OSA particularly on patients with difficult to control asthma, smoker, GERD, obese and nasal disease.
评估哮喘对阻塞性睡眠呼吸暂停（OSA）患者多导睡眠图变量的影响。
一项纵向回顾性研究，使用从睡眠心脏健康研究（SHHS）收集的数据。
纳入的所有2822例患者均患有OSA，其中2599例为非哮喘患者，223例为哮喘患者。非哮喘患者的平均体重指数为28.8kg/m，而哮喘患者为29.5kg/m。非哮喘组和哮喘组的吸烟包年中位数分别为1.42和1.98。性别分布、年龄（岁）、体重指数、第一秒用力呼气容积（FEV）、用力肺活量（FVC）、每小时睡眠中呼吸暂停低通气指数（AHI）≥4%（所有呼吸暂停、低通气伴≥4%氧饱和度下降或觉醒）、呼吸紊乱指数（RDI）≥3%（≥3%氧饱和度下降或觉醒时的总体呼吸分布指数）、睡眠潜伏期、呼吸暂停/低通气睡眠时间百分比和爱泼华嗜睡量表评分均具有统计学意义。非哮喘患者的AHI（12.63次/小时）高于哮喘患者（11.34次/小时），P = 0.0015。非哮喘患者和哮喘患者的RDI分别为23.07和20.53；P = 0.009。发现哮喘患者的睡眠潜伏期更长，为19.8分钟，而非哮喘患者为16分钟（P = 0.008）。哮喘患者的爱泼华嗜睡量表评分较高（9分对8分，P = 0.002）。
在非哮喘亚组中OSA更严重，但哮喘患者的爱泼华嗜睡量表评分和睡眠潜伏期在统计学上显著更高。临床医生应保持警惕，对难以控制的哮喘、吸烟者、胃食管反流病患者、肥胖者和鼻病患者，排除OSA的阈值应较低。
