Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
National Clinical Research Center for Respiratory Diseases, Beijing, China.
J Clin Sleep Med. 2019 Dec 15;15(12):1807-1815. doi: 10.5664/jcsm.8090. Epub 2019 Oct 26.
Despite the clinical and prognostic significance of obstructive sleep apnea (OSA) in chronic respiratory diseases (CRDs), there have been few studies about the possible predictors of OSA and the effect of OSA on quality of life in patients with CRDs. The objectives were to identify physiological and clinical parameters that predict the occurrence and severity of OSA and to investigate the effect of OSA on quality of life in patients with CRDs.
Seventy-three patients with chronic obstructive pulmonary disease (COPD) and 77 patients with fibrotic interstitial lung disease (ILD) underwent overnight polysomnography (PSG) and pulmonary function testing and completed clinical questionnaires. The oximetry tracing was interpreted blindly with respect to the PSG results.
The prevalence of OSA was 44% and 62% in COPD and ILD, respectively. The COPD assessment test item scores related to sleep quality and daily vitality were worse among patients with OSA than among patients without OSA. The STOP-BANG questionnaire (cutoff point ≥ 3) and oxygen desaturation index from the oximetry recording (oxygen desaturation index (ODI) were associated with OSA in CRDs. The STOP-BANG questionnaire with a cutoff point ≥ 3 or 6 had the highest sensitivity and specificity, respectively, in detecting OSA in CRDs. ODI had the best accuracy in identifying OSA and was independently associated with the apnea-hypopnea index in CRDs.
We found OSA to be common and associated with worse sleep quality and less daily vitality in patients with advanced CRDs. The STOP-BANG questionnaire with different cutoff points may help rule in or rule out OSA. Overnight oximetry can be used as a screening tool for OSA and can assist the clinical evaluation of OSA in patients with CRDs.
尽管阻塞性睡眠呼吸暂停（OSA）在慢性呼吸系统疾病（CRD）中具有临床和预后意义，但关于 OSA 的可能预测因素以及 OSA 对 CRD 患者生活质量的影响的研究较少。本研究旨在确定预测 OSA 发生和严重程度的生理和临床参数，并探讨 OSA 对 CRD 患者生活质量的影响。
73 例慢性阻塞性肺疾病（COPD）患者和 77 例纤维化间质性肺疾病（ILD）患者接受了整夜多导睡眠图（PSG）和肺功能检查，并完成了临床问卷。血氧描记图的解释是盲法进行的，与 PSG 结果无关。
COPD 和 ILD 患者中 OSA 的患病率分别为 44%和 62%。与无 OSA 的患者相比，OSA 患者的 COPD 评估测试项目中与睡眠质量和日常活力相关的评分更差。STOP-BANG 问卷（截断值≥3）和血氧描记记录中的氧减指数（ODI）与 CRD 中的 OSA 相关。STOP-BANG 问卷截断值≥3 或 6 时，对 CRD 中 OSA 的敏感性和特异性最高。ODI 在识别 OSA 方面具有最佳的准确性，并且与 CRD 中的呼吸暂停低通气指数独立相关。
我们发现，在晚期 CRD 患者中，OSA 很常见，与睡眠质量较差和日常活力较低相关。不同截断点的 STOP-BANG 问卷可能有助于确定或排除 OSA。整夜血氧描记图可用作 OSA 的筛查工具，并可协助 CRD 患者 OSA 的临床评估。
