Wang Hui, Zhang Ting, Fan Wenhui, Xu Yanming
Department of Neurology, Sichuan Taikang Hospital, Chengdu, Sichuan, China.
Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Front Neurol. 2024 Aug 20;15:1440932. doi: 10.3389/fneur.2024.1440932. eCollection 2024.
Sleep-related breathing disorder (SRBD) is a prevalent non-motor symptom in multiple system atrophy (MSA). However, the reported prevalence of SRBD in MSA from different studies has shown inconsistency. Additionally, only one study has examined the impact of SRBD on both motor and non-motor symptoms in MSA.
Cross-sectional study of 66 patients with probable MSA from China. SRBD was ascertained with polysomnography (PSG). All the MSA individuals were assessed using the Epworth Sleepiness Scale (ESS), Unified Multiple-System Atrophy Rating Scale (UMSARS), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), the Mini-mental State Examination (MMSE), Non-Motor Symptoms Scale (NMSS), and Pittsburgh Sleep Quality Index (PSQI). Moreover, a meta-analysis was conducted by searching studies related to MSA and SRBD in PubMed, Web of Science, Embase, and Cochrane databases. Data were pooled as necessary to calculate prevalence of SBRD with 95% confidence intervals (CI).
Our study included 66 patients with MSA, 52 of whom had a diagnosis of SRBD (78.8%). There were no significant differences between the MSA with SRBD and without SRBD groups on the age, sex, disease onset, disease duration, UMSARS I, II, and IV, the NMSS, the HAMA, HAMD, the ESS the FSS, the MMSE, and the PSQI scales. However, MSA patients with SRBD having a significant higher obstructive apnea index and percentage of snoring during sleep than MSA patients without SRBD [10.0 (4.1-10.6) vs. 0.1 (0-0.3), and 8.3 (5.1-12.2) vs. 4.2 (0-7.5)]. Also, between the two groups, the mean and minimum oxygen concentrations during sleep were lower in MSA patients with SRBD than in those without SRBD [93.7 (93-95) vs. 95.5 (95.8-97), = 0.001] and [83.9 (81.2-89.0) vs. 90.3 (89.8-93.3), = 0.000]. The primary search strategy identified 701 articles, with 10 meeting the inclusion criteria. The overall prevalence of SRBD in a combined sample of 295 MSA patients was found to be 60.5% (95% CI, 43.2-76.5%). Further analysis revealed that the prevalence of SRBD in MSA patients in Asia was 79.2% (95% CI, 54.7-96.3%), which was higher than that in Europe (41.6, 95% CI, 32-51.5%).
The study found a prevalence of 78.8% of SRBD in MSA patients, with a notably higher prevalence in Asia compared to Europe. The majority of SRBD cases in MSA were attributed to obstructive apnea. Furthermore, the presence of SRBD did not show a significant impact on the motor and non-motor symptoms of MSA patients.
睡眠相关呼吸障碍（SRBD）是多系统萎缩（MSA）中一种常见的非运动症状。然而，不同研究报道的MSA中SRBD的患病率存在不一致性。此外，仅有一项研究探讨了SRBD对MSA患者运动和非运动症状的影响。
对66例来自中国的可能患有MSA的患者进行横断面研究。通过多导睡眠图（PSG）确定是否存在SRBD。所有MSA患者均使用爱泼华嗜睡量表（ESS）、统一多系统萎缩评定量表（UMSARS）、汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、简易精神状态检查表（MMSE）、非运动症状量表（NMSS）和匹兹堡睡眠质量指数（PSQI）进行评估。此外还通过检索PubMed、科学网、Embase和Cochrane数据库中与MSA和SRBD相关的研究进行荟萃分析。必要时汇总数据以计算SRBD的患病率及95%置信区间（CI）。
我们的研究纳入了66例MSA患者，其中52例被诊断为SRBD（78.8%）。在年龄、性别、疾病起病、病程、UMSARS I、II和IV、NMSS、HAMA、HAMD、ESS、FSS、MMSE和PSQI量表方面，合并SRBD的MSA组与未合并SRBD的MSA组之间无显著差异。然而合并SRBD的MSA患者的阻塞性呼吸暂停指数和睡眠期间打鼾百分比显著高于未合并SRBD的MSA患者[10.0（4.1 - 10.6）对0.1（0 - 0.3），以及8.3（5.1 - 12.2）对4.2（0 - 7.5）]。此外，两组之间，合并SRBD的MSA患者睡眠期间的平均氧浓度和最低氧浓度低于未合并SRBD的患者[93.7（93 - 95）对95.5（95.8 - 97），P = 0.001]以及[83.9（81.2 - 89.0）对90.3（89.8 - 93.3），P = 0.000]。初步检索策略共识别出文701篇文章，其中10篇符合纳入标准。在295例MSA患者的合并样本中，SRBD的总体患病率为60.5%（95% CI，43.2 - 76.5%）。进一步分析显示，亚洲MSA患者中SRBD的患病率为79.2%（95% CI，54.7 - 96.3%），高于欧洲（41.6%，95% CI，32 - 51.5%）。
该研究发现MSA患者中SRBD的患病率为78.8%，亚洲的患病率显著高于欧洲。MSA中大多数SRBD病例归因于阻塞性呼吸暂停。此外，SRBD的存在对MSA患者的运动和非运动症状未显示出显著影响。
