Liu Yishu, Tan Huiwen, Yu Yue, Zeng Yin, Xiao Li
Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
The Sleep Medicine Center, Shengjing Hospital of China Medical University, Shenyang, China.
Front Neurol. 2020 Sep 11;11:988. doi: 10.3389/fneur.2020.00988. eCollection 2020.
The aim of this study was to explore the clinical characteristics of different sleep perception types of obstructive sleep apnea-hypopnea syndrome (OSAHS) patients and to analyze the correlation between sleep perception and polysomnography (PSG) indicators in OSAHS patients. We retrospectively analyzed 355 patients diagnosed with OSAHS by PSG at the Sleep Medicine Center of Shengjing Hospital of China Medical University. Patients saw a doctor due to snoring and daytime sleepiness from March 2017 to March 2018. We excluded the patients who are <18 years old, had a history of OSAHS treatment, had other sleep and psychiatric disorders, and could not provide complete data. According to the patients' explanation, medical history, PSG indicators, and morning questionnaire after PSG, the patients were divided into normal sleep perception (NSP), positive sleep perception abnormality (PSPA), and negative sleep perception abnormality (NSPA). We analyze the demographic characteristics and PSG of the three groups with ANOVA and non-parametric tests. In addition, we conducted correlation analysis between sleep perception and PSG indicators. Of OSAHS patient, 55.5% had sleep perception abnormalities, of which 35.5% were positive-perception abnormalities and 20% were negative-perception abnormalities. From the analysis of PSG indicators, the sleep perception abnormality was related to the frequency of spontaneous arousal of the patient ( = 0.003) and was not related to the slight arousal caused by respiratory events, oxygen desaturations, and limb movement events. OSAHS patients with PSPA had a higher oxygen desaturation index ( = 0.046) but no significant difference in test. PSPA group had significantly lower rapid eye movement (REM) latency and sleep efficiency and more wake after sleep onset (WASO) than had the other sleep perception groups. Multivariate linear regression analyses after adjusting for age and sex revealed that sleep perception was related to lowest oxygen saturation (LSaO), TS90%, sleep efficiency, and WASO. Sleep perception abnormality is common in OSAHS patients. OSAHS patients with different sleep perception types have different PSG profiles. The OSAHS patients with PSPA have more severe hypoxia levels at night that require timely personalized treatment.
本研究旨在探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者不同睡眠感知类型的临床特征，并分析OSAHS患者睡眠感知与多导睡眠图（PSG）指标之间的相关性。我们回顾性分析了在中国医科大学附属盛京医院睡眠医学中心通过PSG诊断为OSAHS的355例患者。患者于2017年3月至2018年3月因打鼾和日间嗜睡就诊。我们排除了年龄<18岁、有OSAHS治疗史、有其他睡眠和精神障碍以及无法提供完整数据的患者。根据患者的解释、病史、PSG指标以及PSG后的早晨问卷，将患者分为正常睡眠感知（NSP）、阳性睡眠感知异常（PSPA）和阴性睡眠感知异常（NSPA）。我们采用方差分析和非参数检验分析三组的人口统计学特征和PSG。此外，我们对睡眠感知与PSG指标进行了相关性分析。在OSAHS患者中，55.5%存在睡眠感知异常，其中35.5%为阳性感知异常，20%为阴性感知异常。从PSG指标分析来看，睡眠感知异常与患者的自发觉醒频率相关（P = 0.003），与呼吸事件、氧饱和度下降和肢体运动事件引起的轻微觉醒无关。PSPA的OSAHS患者有更高的氧饱和度下降指数（P = 0.046），但在测试中无显著差异。PSPA组的快速眼动（REM）潜伏期和睡眠效率显著低于其他睡眠感知组，且睡眠开始后觉醒（WASO）更多。在调整年龄和性别后的多变量线性回归分析显示，睡眠感知与最低氧饱和度（LSaO）、TS90%、睡眠效率和WASO相关。睡眠感知异常在OSAHS患者中很常见。不同睡眠感知类型的OSAHS患者有不同的PSG特征。PSPA的OSAHS患者夜间缺氧水平更严重，需要及时进行个性化治疗。
