睡眠呼吸暂停严重程度的夜间波动：诊断及治疗意义
Night-to-night fluctuations in sleep apnea severity: diagnostic and treatment implications.
作者信息
Dzierzewski Joseph M, Dautovich Natalie D, Rybarczyk Bruce, Taylor Samuel A
机构信息
Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.
Department of Neurology, Virginia Commonwealth University, Richmond, Virginia.
出版信息
J Clin Sleep Med. 2020 Apr 15;16(4):539-544. doi: 10.5664/jcsm.8272.
STUDY OBJECTIVES
Sleep apnea is a common disorder with serious consequences; however, effective treatments are available. Successful implementation of treatment strategies relies on accurate diagnosis, which may be hampered by the presence of substantial nightly fluctuation in sleep apnea severity. We examined the amount of nightly fluctuation in the severity of sleep apnea around commonly used diagnostic and treatment cut points in individuals who underwent two nights of home sleep apnea testing (HSAT).
METHODS
A nationwide retrospective cohort study of adults thought to have sleep apnea underwent two nights of HSAT between 2005 and 2017.
RESULTS
The study included 47,423 adults (mean age, 55.2 [14.6] years; 53.7% male). The average apnea-hypopnea index (AHI) for the sample was 26.9. The average amount of nightly fluctuation in AHI was 5.5. More than a third of the sample, 16,115 individuals, had fluctuations between diagnostic cut points across the two nights of HSAT. The negative predictive value of the HSAT in the first night was 47.42%, 73.57%, and 88.65% for detecting an AHI ≥ 5, AHI ≥ 15, and AHI ≥ 30, respectively.
CONCLUSIONS
The addition of a second night of HSAT has the potential to reduce the likelihood of missed diagnoses that could result from nightly fluctuation in the severity of sleep apnea.
研究目的
睡眠呼吸暂停是一种常见疾病，后果严重；然而，有有效的治疗方法。治疗策略的成功实施依赖于准确的诊断，而睡眠呼吸暂停严重程度的夜间大幅波动可能会妨碍诊断。我们研究了在接受两晚家庭睡眠呼吸暂停测试（HSAT）的个体中，睡眠呼吸暂停严重程度在常用诊断和治疗切点附近的夜间波动量。
方法
一项对全国范围内被认为患有睡眠呼吸暂停的成年人进行的回顾性队列研究，这些成年人在2005年至2017年间接受了两晚的HSAT。
结果
该研究纳入了47423名成年人（平均年龄55.2[14.6]岁；53.7%为男性）。样本的平均呼吸暂停低通气指数（AHI）为26.9。AHI的平均夜间波动量为5.5。超过三分之一的样本（16115人）在两晚的HSAT中，诊断切点之间存在波动。HSAT第一晚检测AHI≥5、AHI≥15和AHI≥30的阴性预测值分别为47.42%、73.57%和88.65%。
结论
增加第二晚的HSAT有可能降低因睡眠呼吸暂停严重程度的夜间波动而导致漏诊的可能性。
Zotero 插件