Gülbay Banu, Acıcan Turan, Erdemir Işık Merda, Çiftci Fatma, Önen Zeynep Pınar
Department of Chest Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey.
Tuberk Toraks. 2019 Dec;67(4):258-264. doi: 10.5578/tt.68905.
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.
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.
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).
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.
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。
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。
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）。
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。
