Hou Shujie, Zhu Guojia, Liu Xu, Wang Chuan, Liang Junchao, Hao Wei, Kong Lili
Graduate School of Hebei University of Traditional Chinese Medicine, Shijiazhuang, China.
School of Basic Medicine, Hebei University of Traditional Chinese Medicine, Shijiazhuang, China.
Front Neurol. 2024 Jul 24;15:1370609. doi: 10.3389/fneur.2024.1370609. eCollection 2024.
Preoperative obstructive sleep apnea (OSA) is supposed to be the abnormally high occurrence of OSA the night before surgery under general anesthesia. This study aimed to evaluate the prevalence preoperative OSA using cardiopulmonary coupling (CPC) and its correlation with imbalance of sympathetic/parasympathetic nervous system.
A total of 550 patients with plans to receive surgery under general anesthesia were enrolled. All patients were assigned to wear CPC on the night before surgery until the next day. Sleep quality characteristics, heart rate variation parameters, and apnea-hypopnea index were acquired. The diagnosis of pre-existing OSA was not considered in the current study.
According to apnea-hypopnea index, 28.4%, 32.2%, 26.2%, and 13.3% patients were assessed as no, mild, moderate, and severe operative OSA, respectively. Multivariate logistic regression model revealed that higher age [ < 0.001, odds ratio (OR) = 1.043] was independently and positively associated with preoperative OSA; heart rate variation parameters representing the imbalance of sympathetic/parasympathetic nervous system, such as higher low-frequency ( < 0.001, OR = 1.004), higher low-frequency/high-frequency ratio ( = 0.028, OR = 1.738), lower NN20 count divided by the total number of all NN intervals (pNN20; < 0.001, OR = 0.950), and lower high-frequency ( < 0.001, OR = 0.998), showed independent relationships with a higher probability of preoperative OSA. Higher age ( = 0.005, OR = 1.024), higher very-low-frequency ( < 0.001, OR = 1.001), and higher low-frequency/high-frequency ratio ( = 0.003, OR = 1.655) were associated with a higher probability of moderate-to-severe preoperative OSA, but higher pNN10 ( < 0.001, OR = 0.951) was associated with a lower probability of moderate-to-severe preoperative OSA.
Preoperative OSA is prevalent. Higher age and imbalance of sympathetic/parasympathetic nervous system are independently and positively associated with a higher occurrence of preoperative OSA. CPC screening may promote the management of preoperative OSA.
术前阻塞性睡眠呼吸暂停（OSA）被认为是指在全身麻醉手术前一晚OSA异常高发的情况。本研究旨在评估使用心肺耦合（CPC）技术检测术前OSA的患病率及其与交感神经/副交感神经系统失衡的相关性。
共纳入550例计划接受全身麻醉手术的患者。所有患者均被安排在手术前一晚佩戴CPC设备直至次日。获取睡眠质量特征、心率变异性参数及呼吸暂停低通气指数。本研究未考虑既往已存在的OSA诊断情况。
根据呼吸暂停低通气指数，分别有28.4%、32.2%、26.2%和13.3%的患者被评估为无、轻度、中度和重度手术相关OSA。多因素逻辑回归模型显示，较高年龄（<0.001，比值比[OR]=1.043）与术前OSA独立正相关；代表交感神经/副交感神经系统失衡的心率变异性参数，如较高的低频成分（<0.001，OR=1.004）、较高的低频/高频比值（=0.028，OR=1.738）、较低的NN20计数除以所有NN间期总数（pNN20；<0.001，OR=0.950）以及较低的高频成分（<0.001，OR=0.998），均与术前OSA发生概率较高呈独立相关。较高年龄（=0.005，OR=1.024）、较高的极低频成分（<0.001，OR=1.001）以及较高的低频/高频比值（=0.003，OR=1.655）与中度至重度术前OSA发生概率较高相关，但较高的pNN10（<0.001，OR=0.951）与中度至重度术前OSA发生概率较低相关。
术前OSA较为普遍。较高年龄和交感神经/副交感神经系统失衡与术前OSA较高发生率独立正相关。CPC筛查可能有助于促进术前OSA的管理。
