Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Geriatrics Institute, Tianjin, China.
Chest Clinical College, Tianjin Medical University, Tianjin, 300222, China.
Sleep Breath. 2023 Oct;27(5):1839-1845. doi: 10.1007/s11325-023-02776-6. Epub 2023 Feb 28.
Central sleep apnea (CSA) is usually distinguished from obstructive sleep apnea (OSA). In fact, CSA is often a component of severe sleep apnea hypopnea syndrome (SAHS), rather than occurring alone. We investigated the clinical characteristics and polysomnography (PSG) parameters of CSA components in patients with severe SAHS.
The clinical characteristics and PSG parameters were retrospectively analyzed.
Pure or dominant CSA was rare (5% of all patients). Of all patients with CSA, 72% also exhibited other apnea subtypes that contributed to severe SAHS. Among patients with severe SAHS, those with CSA were more likely than others to be older; thinner; exhibit higher prevalences of comorbid coronary heart disease, arrhythmia, and heart failure; a higher apnea/hypopnea index (AHI); mixed apnea index (MAI); an elevated oxygen desaturation index (ODI); and more nighttime oxygen saturation levels < 90%. Multivariate logistic regression analysis revealed that older age, comorbid arrhythmia or heart failure, and an elevated ODI were independently associated with CSA.
Patients who complain of snoring or apnea may be better evaluated by comprehensive PSG prior to treatment if they are old, show greater hypoxia, or suffer from arrhythmia and/or heart failure, because such patients are more likely than others to exhibit CSA.
中枢性睡眠呼吸暂停（CSA）通常与阻塞性睡眠呼吸暂停（OSA）区分开来。事实上，CSA 通常是严重睡眠呼吸暂停低通气综合征（SAHS）的一个组成部分，而不是单独发生。我们研究了严重 SAHS 患者中 CSA 成分的临床特征和多导睡眠图（PSG）参数。
回顾性分析临床特征和 PSG 参数。
单纯或主要 CSA 很少见（占所有患者的 5%）。在所有 CSA 患者中，72%的患者还存在其他导致严重 SAHS 的呼吸暂停亚型。在严重 SAHS 患者中，CSA 患者比其他患者更可能年龄较大；更瘦；更常见合并冠心病、心律失常和心力衰竭；呼吸暂停/低通气指数（AHI）更高；混合呼吸暂停指数（MAI）更高；氧减饱和指数（ODI）升高；夜间血氧饱和度水平<90%的情况更多。多变量逻辑回归分析表明，年龄较大、合并心律失常或心力衰竭以及 ODI 升高与 CSA 独立相关。
如果患者年龄较大、存在更严重的缺氧、患有心律失常和/或心力衰竭，他们在接受治疗前可能会更好地通过综合 PSG 进行评估，因为这些患者比其他患者更有可能出现 CSA。
