Department of Pulmonology, Dr. Suat Seren Chest Diseases and Surgery Education and Training Hospital, University of Health Sciences, Izmir Faculty of Medicine, Izmir, Turkey.
Department of Pulmonology, Dr. Suat Seren Chest Diseases and Surgery Education and Training Hospital, Izmir, Turkey.
Sleep Breath. 2024 Mar;28(1):103-112. doi: 10.1007/s11325-023-02868-3. Epub 2023 Jul 8.
The purpose of this study was to investigate the long-term mortality rates of patients with obstructive sleep apnea (OSA) who received an overnight polysomnogram (PSG) for obtaining the diagnosis and to determine the relationship between PSG parameters and overall mortality.
Between 2007 and 2013, patients who had overnight PSG and were diagnosed with OSA were included in the study. Factors which are thought to influence mortality were assessed for 5-year and overall survival using the log rank test and Kaplan-Meier survival curves. Using multivariable Cox regression analysis, a model was constructed for factors influencing 5-year and overall survival.
A total of 762 patients with a mean age of 52.7 (±10.8) and a dominance of men (74.7%) were studied. Gender, OSA severity subgroups, and apnea hypopnea index (AHI) were not statistically significantly associated with either 5-year or overall mortality (p<0.05 for both). Age, having a cardiovascular comorbidity, proportion of rapid eye movement (%REM), and total sleep time with an oxyhemoglobin saturation of less than 90% (T90) all showed a significant correlation with overall all-cause mortality in the model. For 5-year mortality and overall mortality, the hazard ration (HR) for T90 was 3.6 (95% CI (1.6-8.0) p=0.001) and 3 (95% CI (1.6-5.7) p=0.001), respectively.
The study findings suggest that not AHI but PSG parameters of hypoxia, mainly T90, having cardiovascular comorbidity, and %REM sleep were significant risk factors for all-cause mortality in patients with OSA. The association of OSA, hypoxia, and mortality is an area that deserves further study.
本研究旨在探讨接受过夜多导睡眠图（PSG）诊断阻塞性睡眠呼吸暂停（OSA）患者的长期死亡率，并确定 PSG 参数与总死亡率之间的关系。
在 2007 年至 2013 年间，纳入了接受过夜 PSG 并诊断为 OSA 的患者。使用对数秩检验和 Kaplan-Meier 生存曲线评估了 5 年和总生存率的影响死亡率的因素。使用多变量 Cox 回归分析构建了影响 5 年和总生存率的模型。
共纳入 762 例患者，平均年龄为 52.7（±10.8）岁，男性居多（74.7%）。性别、OSA 严重程度亚组和呼吸暂停低通气指数（AHI）与 5 年或总死亡率均无统计学显著相关性（均 p<0.05）。年龄、存在心血管合并症、快速眼动（REM）比例和总睡眠时间内血氧饱和度低于 90%（T90）的比例与模型中的全因总死亡率均显著相关。对于 5 年死亡率和总死亡率，T90 的危险比（HR）分别为 3.6（95%可信区间（1.6-8.0），p=0.001）和 3（95%可信区间（1.6-5.7），p=0.001）。
研究结果表明，导致 OSA 患者全因死亡率的显著危险因素不是 AHI，而是缺氧的 PSG 参数，主要是 T90、存在心血管合并症和 REM 睡眠。OSA、缺氧和死亡率之间的关联是一个值得进一步研究的领域。
