Okura Mutsumi, Nonoue Shigeru, Tsujisaka Akiko, Haraki Shingo, Yokoe Chizuko, Taniike Masako, Kato Takafumi
Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan.
Sleep Center, Osaka Kaisei Hospital, Osaka, Japan.
J Clin Sleep Med. 2020 Aug 15;16(8):1303-1310. doi: 10.5664/jcsm.8498.
The present study aimed to investigate the occurrence and characteristics of apnea-hypopnea events in young nonobese healthy Japanese participants.
One hundred and three young adult participants without sleep complaints (men: 56; women: 47; age: 24.5 ± 3.0 years; body mass index: 20.9 ± 1.8 kg/m²) underwent 2-night polysomnography. Data on the 2nd night were scored according to American Academy of Sleep Medicine criteria version 2.1. The apnea-hypopnea index (AHI) was estimated. The arousal threshold was calculated in participants with AHI ≥ 5 events/h. Apnea-hypopnea events were rescored by 3 other criteria issued by the American Academy of Sleep Medicine (AASM): Chicago criteria in 1999 and recommended and alternative criteria in 2007.
Participants had good sleep characterized by high sleep efficiency (93.2%). Mean AHI of AASM 2.1 recommended criteria was 4.0 ± 5.3 events/h. AHI was significantly higher in men (median [range] = 4.0[.3-35.8] events/h) than in women (1.6 [.1-18.1] events/h). The prevalence rates of AHI ≥ 5 events/h and ≥ 15 events/h were 25.2 and 3.9%, respectively. The arousal threshold was estimated as -7.7 ± 2.6 cm H₂O. AHI was lower for AASM 2007 recommended criteria (.8 [.0-18.2 events/h]) and AASM 2007 alternative (2.0 [.1-32.2] events/h) than for AASM version 2.1 recommended criteria (2.4 [.1-32.9] events/h) and AASM Chicago (4.6 [.1-35.8] events/h). The percentage of participants with AHI ≥ 5 events/h was approximately 2-fold higher with AASM Chicago (44.6%) than with AASM version 2.1 recommended criteria.
The present study demonstrated that 25% of young nonobese Japanese participants had subclinical obstructive sleep apnea. The presence of frequent airflow limitations may be a risk factor for the development of obstructive sleep apnea in Japanese individuals.
本研究旨在调查年轻非肥胖健康日本参与者中呼吸暂停-低通气事件的发生情况及特征。
103名无睡眠主诉的年轻成年参与者（男性56名；女性47名；年龄：24.5±3.0岁；体重指数：20.9±1.8kg/m²）接受了为期两晚的多导睡眠监测。第二晚的数据根据美国睡眠医学学会2.1版标准进行评分。计算呼吸暂停-低通气指数（AHI）。对AHI≥5次/小时的参与者计算觉醒阈值。呼吸暂停-低通气事件根据美国睡眠医学学会（AASM）发布的其他3项标准重新评分：1999年的芝加哥标准以及2007年的推荐标准和替代标准。
参与者睡眠良好，睡眠效率高（93.2%）。AASM 2.1推荐标准的平均AHI为4.0±5.3次/小时。男性的AHI（中位数[范围]=4.0[0.3 - 35.8]次/小时）显著高于女性（1.6[0.1 - 18.1]次/小时）。AHI≥5次/小时和≥15次/小时的患病率分别为25.2%和3.9%。觉醒阈值估计为-7.7±2.6cmH₂O。AASM 2007推荐标准（0.8[0.0 - 18.2次/小时]）和AASM 2007替代标准（2.0[0.1 - 32.2]次/小时）的AHI低于AASM 2.1推荐标准（2.4[0.1 - 32.9]次/小时）和AASM芝加哥标准（4.6[0.1 - 35.8]次/小时）。AHI≥5次/小时的参与者比例，AASM芝加哥标准（44.6%）约为AASM 2.1推荐标准的2倍。
本研究表明，25%的年轻非肥胖日本参与者存在亚临床阻塞性睡眠呼吸暂停。频繁出现气流受限可能是日本人发生阻塞性睡眠呼吸暂停的一个危险因素。
