沙特人群中阻塞性睡眠呼吸暂停严重程度的最佳气道正压需求及多导睡眠图指标

Optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the Saudi population.

作者信息

Bamagoos Ahmad A, Alshaynawi Shahad A, Gari Atheer S, Badawi Atheer M, Alhiniah Mudhawi H, Alshahrani Asma A, Rajab Renad R, Bahaj Reem K, Alhejaili Faris, Wali Siraj O

机构信息

Department of Physiology, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.

Sleep Medicine and Research Centre, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

出版信息

Ann Thorac Med. 2023 Jan-Mar;18(1):31-38. doi: 10.4103/atm.atm_183_22. Epub 2023 Jan 25.

DOI:10.4103/atm.atm_183_22

PMID:36968331

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10034820/

Abstract

CONTEXT

Positive airway pressure (PAP) is the first-line therapy for obstructive sleep apnea (OSA). Overnight PAP titration for determining optimal PAP requirements is expensive and often inconvenient. Prediction of optimal PAP requirements from diagnostic polysomnography via mathematical equations is possible but variable across populations.

AIMS

We aimed to (1) determine the optimal PAP requirement, (2) determine differences in optimal PAP requirements across OSA severity groups, (3) determine the relationship between optimal PAP requirement and diagnostic polysomnography measurements of OSA severity, and (4) develop a pilot equation to predict the optimal PAP requirement from diagnostic polysomnography in a sample from the Saudi population.

METHODS

We analyzed records pertaining to adult OSA patients ( = 215; 63% of males) who underwent standardized diagnostic and titration polysomnography in our sleep laboratory between 2015 and 2019. Demographic, anthropometric, and clinical information were also collected for the analysis. Inferential statistics were performed for comparisons between diagnostic and titration studies and between OSA severity groups. Regression analyses were also performed to determine the potential predictors of optimal PAP requirements. Data were presented as the mean (± standard deviation) or median (25-75 quartiles) according to normality.

RESULTS

The median optimal PAP requirement was 13 (9-17) cmHO. The optimal PAP requirement was significantly greater for male versus female participants (14 [10-17] vs. 12 [8-16] cmHO) and for participants with severe OSA (16 [12-20] cmHO, = 119) versus those with moderate (11 [8-14] cmHO, = 63) or mild (9 [7-12] cmHO, = 33) OSA. When combined, nadir oxygen saturation, oxygen desaturation index, and arousal index could be used to predict the optimal PAP requirement ( = 0.39, = 34.0, < 0.001).

CONCLUSIONS

The optimal PAP requirement in the Saudi population is relatively high and directly correlated with OSA severity. Diagnostic polysomnography measurements of OSA severity predicted the optimal PAP requirement in this sample. Prospective validation is warranted.

摘要

背景

气道正压通气（PAP）是阻塞性睡眠呼吸暂停（OSA）的一线治疗方法。通过夜间PAP滴定来确定最佳PAP需求既昂贵又常常不方便。通过数学方程从诊断性多导睡眠图预测最佳PAP需求是可行的，但因人群而异。

目的

我们旨在（1）确定最佳PAP需求，（2）确定不同OSA严重程度组之间最佳PAP需求的差异，（3）确定最佳PAP需求与OSA严重程度的诊断性多导睡眠图测量值之间的关系，以及（4）开发一个初步方程，以从沙特人群样本的诊断性多导睡眠图预测最佳PAP需求。

方法

我们分析了2015年至2019年期间在我们睡眠实验室接受标准化诊断和滴定多导睡眠图检查的成年OSA患者（n = 215；63%为男性）的记录。还收集了人口统计学、人体测量学和临床信息用于分析。对诊断性和滴定性研究之间以及OSA严重程度组之间进行了推断统计比较。还进行了回归分析以确定最佳PAP需求的潜在预测因素。数据根据正态性以均值（±标准差）或中位数（第25 - 75四分位数）表示。

结果

最佳PAP需求的中位数为13（9 - 17）cmH₂O。男性参与者的最佳PAP需求显著高于女性参与者（14 [10 - 17] vs. 12 [8 - 16] cmH₂O），重度OSA参与者（16 [12 - 20] cmH₂O，n = 119）的最佳PAP需求高于中度（11 [8 - 14] cmH₂O，n = 63）或轻度（9 [7 - 12] cmH₂O，n = 33）OSA参与者。当结合使用时，最低氧饱和度、氧去饱和指数和觉醒指数可用于预测最佳PAP需求（r = 0.39，F = 34.0，P < 0.001）。