Altıntop Geçkil Ayşegül, Yetkin Özkan
Clinic of Chest Diseases, Malatya Training and Research Hospital, Malatya, Turkey.
Department of Chest Diseases, Faculty of Medicine, Inonu University, Malatya, Turkey.
Tuberk Toraks. 2019 Sep;67(3):205-210. doi: 10.5578/tt.68364.
In this study, changes in energy metabolism before and after treatment were compared in obstructive sleep apnea syndrome (OSAS) patients who received positive airway pressure therapy.
Thirty-nine patients (22 male, 17 female) were admitted to study. Patients for PAP therapy who had moderate to severe in polysomnography were included. Values of energy metabolism were recorded during three days via metaboic holter device, before and after PAP therapy.
The mean age of the patients was 51.53 ± 11.16 year. In 15 (38.46%) of the patients BPAP, and in 24 (61.54%) of the patients CPAP treatment started. Three days after using metabolic holter device: the total daily energy consumption of the patients was found to be 482,4 ± 296.1 kcal/day before treatment and 524.5 ± 343.1 kcal/day after treatment (p<0.0001); patients' daily physical activity was 7867 ± 3319 steps/day before treatment and 12.416 ± 1451 steps/day after treatment, which was considered statistically significant (p<0001); the total daily resting period of the patients was 7.90 ± 1.36 hours/day before treatment and 7.44 ± 1.42 hours/day after treatment, considered statistically significant (p<0001); the total sleep duration of the patients was 5.50 ± 1.88 hours/day before treatment and 5.87 ± 1.20 hours/ day after treatment, considered statistically significant (p<0001).
In our study, we found that daily physical activity and energy consumption increased with PAP treatment. With PAP treatment, obesity, diabetes and hypertension can be controlled. In our study, since PAP treatment was effective with effective sleep, the immobilization time was decreased and therefore the duration of daytime physical activity was prolonged. With these effects, patients' compliance with treatment increases. In conclusion, PAP treatment should be recommended in patients with moderate and severe OSAS.
在本研究中，对接受气道正压通气治疗的阻塞性睡眠呼吸暂停综合征（OSAS）患者治疗前后的能量代谢变化进行了比较。
39例患者（22例男性，17例女性）纳入研究。纳入多导睡眠图检查为中度至重度的接受持续气道正压通气（PAP）治疗的患者。通过代谢动态心电图监测仪记录PAP治疗前后三天的能量代谢值。
患者的平均年龄为51.53±11.16岁。15例（38.46%）患者开始使用双水平气道正压通气（BPAP）治疗，24例（61.54%）患者开始使用持续气道正压通气（CPAP）治疗。使用代谢动态心电图监测仪三天后：治疗前患者每日总能量消耗为482.4±296.1千卡/天，治疗后为524.5±343.1千卡/天（p<0.0001）；患者每日身体活动量治疗前为7867±3319步/天，治疗后为12416±1451步/天，差异有统计学意义（p<0.0001）；患者每日总静息时间治疗前为7.90±1.36小时/天，治疗后为7.44±1.42小时/天，差异有统计学意义（p<0.0001）；患者总睡眠时间治疗前为5.50±1.88小时/天，治疗后为5.87±1.20小时/天，差异有统计学意义（p<0.0001）。
在我们的研究中，我们发现PAP治疗后患者的每日身体活动和能量消耗增加。通过PAP治疗，可以控制肥胖、糖尿病和高血压。在我们的研究中，由于PAP治疗通过改善有效睡眠起作用，减少了静息时间，从而延长了白天身体活动的时长。有了这些效果，患者对治疗的依从性增加。总之，对于中度和重度OSAS患者，应推荐使用PAP治疗。
