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[肥胖与非肥胖阻塞性睡眠呼吸暂停患者的临床及多导睡眠图差异]

[The clinical and polysomnographic differences between obese and non-obese patients with obstructive sleep apnea].

作者信息

Gülbay Banu, Acıcan Turan, Erdemir Işık Merda, Çiftci Fatma, Önen Zeynep Pınar

机构信息

Department of Chest Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey.

出版信息

Tuberk Toraks. 2019 Dec;67(4):258-264. doi: 10.5578/tt.68905.

Abstract

INTRODUCTION

Obesity has been considered to be one of the important risk factor for obstructive sleep apnea (OSA). We aimed to investigate the clinical and polysomnographic differences of obese and non-obese OSA patients and how these differences, if any, can be reflected in our daily clinical practice.

MATERIALS AND METHODS

The polysomnographic data of 157 consecutive patients that underwent a sleep study were analyzed. Ninety-nine adult patients with a diagnosis of OSA [apnea-hypopnea index (AHI) ≥ 5/hour] were retrospectively assesed in two groups in respect of obese (BMI ≥ 30 kg/m2) or non-obese (BMI <30 kg/m2) according to body mass index (BMI). The clinical and polysomnographic results of the patients in both groups were compared.

RESULT

Between 2010 and 2011, 99 (31 K/68 M) of 157 patients underwent polysomnography were diagnosed with OSA (AHI ≥ 5/hour). Thirthy six patients with OSA (36.4%) were non-obese and 63 patients (63.6%) were obese. There were no differences in the symptoms related to OSA between two groups (p> 0.05). Although there was no statistical significance, the age of the obese patients (50.5 ± 12.7 years) was lower than those of the non-obese (54.9 ± 10.0 years) in polysomnography their total sleep time was shorter and sleep latency later, and sleep efficiency, arousal index, N3%, and REM% were lower and N1% was higher (p> 0.05). While in the obese OSA patients the AHI and Epworth Sleepiness sclae were higher (respectively; p= 0.028, p= 0.01), average oxygen saturation at sleep was lower (p<0.001). While obese OSA patients had similar ratio of hypertension and atherosclerotic heart disease with non-obese OSA patients, whereas diabetes mellitus was higher in obese OSA group (p= 0.036). The use of antidepressant drug was more common in the non-obese patients than the obese patients (p= 0.011).

CONCLUSIONS

Although obese OSA patients have a more severe disease compared to nonobese OSA patients, there were no significant differences in clinical and polysomnographics findings between two groups. Should be noted that OSA may occur in non-obese patients.

摘要

引言

肥胖被认为是阻塞性睡眠呼吸暂停(OSA)的重要危险因素之一。我们旨在研究肥胖和非肥胖OSA患者的临床及多导睡眠图差异,以及这些差异(若存在)如何在我们的日常临床实践中体现。

材料与方法

分析了157例连续接受睡眠研究患者的多导睡眠图数据。根据体重指数(BMI),将99例诊断为OSA(呼吸暂停低通气指数[AHI]≥5次/小时)的成年患者回顾性分为肥胖组(BMI≥30kg/m²)和非肥胖组(BMI<30kg/m²)。比较两组患者的临床和多导睡眠图结果。

结果

2010年至2011年期间,157例接受多导睡眠图检查的患者中有99例(31例女性/68例男性)被诊断为OSA(AHI≥5次/小时)。36例OSA患者(36.4%)为非肥胖,63例患者(63.6%)为肥胖。两组间与OSA相关的症状无差异(p>0.05)。尽管无统计学意义,但肥胖患者在多导睡眠图检查中的年龄(50.5±12.7岁)低于非肥胖患者(54.9±10.0岁),其总睡眠时间较短,睡眠潜伏期较晚,睡眠效率、觉醒指数、N3%和快速眼动睡眠(REM)%较低,N1%较高(p>0.05)。肥胖OSA患者的AHI和爱泼沃斯思睡量表得分较高(分别为p=0.028,p=0.01),睡眠时的平均血氧饱和度较低(p<0.001)。肥胖OSA患者与非肥胖OSA患者的高血压和动脉粥样硬化性心脏病发生率相似,而肥胖OSA组的糖尿病发生率较高(p=0.036)。非肥胖患者使用抗抑郁药比肥胖患者更常见(p=0.011)。

结论

尽管肥胖OSA患者的病情比非肥胖OSA患者更严重,但两组间的临床和多导睡眠图检查结果无显著差异。应注意非肥胖患者也可能发生OSA。

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