实验室和家庭多导睡眠图检查时的体位与在家习惯性睡眠体位的比较。
Body position during laboratory and home polysomnography compared to habitual sleeping position at home.
机构信息
Monash Lung, Sleep, Allergy & Immunology, Monash Health, Melbourne, Australia.
School of Clinical Sciences, Monash University, Melbourne, Australia.
出版信息
J Clin Sleep Med. 2022 Sep 1;18(9):2103-2111. doi: 10.5664/jcsm.9990.
STUDY OBJECTIVES
Supine-predominant obstructive sleep apnea (OSA) is highly prevalent. The proportion of time spent in the supine position may be overrepresented during polysomnography, which would impact on the apnea-hypopnea index (AHI) and have important clinical implications. We aimed to investigate the difference in body position during laboratory or home polysomnography compared to habitual sleep and estimate its effect on OSA severity. Secondary aims were to evaluate the consistency of habitual sleeping position and accuracy of self-reported sleeping position.
METHODS
Patients undergoing diagnostic laboratory or home polysomnography were recruited. Body position was recorded using a neck-worn device. Habitual sleeping position was the average time spent supine over 3 consecutive nights at home. Primary outcomes were the proportion of sleep time spent supine (% time supine) and AHI adjusted for habitual sleeping position.
RESULTS
Fifty-seven patients who underwent laboratory polysomnography and 56 who had home polysomnography were included. Compared to habitual sleep, % time supine was higher during laboratory polysomnography (mean difference 14.1% [95% confidence interval: 7.2-21.1]; = .0002) and home polysomnography (7.1% [95% confidence interval 0.9-13.3]; = .03). Among those with supine-predominant OSA, there was a trend toward lower adjusted AHI than polysomnography-derived AHI ( = .07), changing OSA severity in 31.6%. There was no significant between-night difference in % time supine during habitual sleep ( = .4). Self-reported % time supine was inaccurate (95% limits of agreement -49.2% to 53.9%).
CONCLUSIONS
More time was spent in the supine position during polysomnography compared to habitual sleep, which may overestimate OSA severity for almost one-third of patients with supine-predominant OSA.
CLINICAL TRIAL REGISTRATION
Registry: Australia and New Zealand Clinical Trials Registry (ANZCTR); Title: Sleeping position during sleep tests and at home; Identifier: ACTRN12618000628246; URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374873&isReview=true.
CITATION
Yo SW, Joosten SA, Wimaleswaran H, et al. Body position during laboratory and home polysomnography compared to habitual sleeping position at home. . 2022;18(9):2103-2111.
研究目的
仰卧位为主的阻塞性睡眠呼吸暂停（OSA）非常普遍。在多导睡眠图检查中，仰卧位的时间比例可能会被高估，这将影响到呼吸暂停低通气指数（AHI），并具有重要的临床意义。我们旨在研究与习惯性睡眠相比，实验室或家庭多导睡眠图检查中的体位差异，并评估其对 OSA 严重程度的影响。次要目的是评估习惯性睡眠体位的一致性和自我报告睡眠体位的准确性。
方法
招募接受诊断性实验室或家庭多导睡眠图检查的患者。使用颈戴式设备记录体位。习惯性睡眠体位是在家中连续 3 晚平均仰卧时间。主要结局是仰卧时间百分比（%时间仰卧）和调整习惯性睡眠体位后的 AHI。
结果
共纳入 57 例接受实验室多导睡眠图检查和 56 例家庭多导睡眠图检查的患者。与习惯性睡眠相比，实验室多导睡眠图检查时仰卧时间百分比更高（平均差异 14.1%[95%置信区间：7.2-21.1]； =.0002），家庭多导睡眠图检查时也更高（7.1%[95%置信区间：0.9-13.3]； =.03）。在以仰卧为主的 OSA 患者中，调整后的 AHI 比多导睡眠图衍生的 AHI 有下降趋势（ =.07），这改变了 31.6%的 OSA 严重程度。在习惯性睡眠期间，%时间仰卧的夜间差异无统计学意义（ =.4）。自我报告的%时间仰卧不准确（95%一致性区间为-49.2%至 53.9%）。
结论
与习惯性睡眠相比，多导睡眠图检查时仰卧位时间更长，这可能导致近三分之一以仰卧为主的 OSA 患者的 OSA 严重程度被高估。
临床试验注册
澳大利亚和新西兰临床试验注册中心（ANZCTR）；标题：睡眠测试和在家时的睡眠体位；标识符：ACTRN12618000628246；网址：https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374873&isReview=true。
引用
Yo SW, Joosten SA, Wimaleswaran H, et al. Body position during laboratory and home polysomnography compared to habitual sleeping position at home.. 2022;18(9):2103-2111.
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