Mao Yuhao, Li Qi, Zou Xueliang, Zhong Zhijun, Ouyang Qian, Gan Chunmei, Yi Fang, Luo Yaxing, Cheng Zilin, Yao Dongyuan
Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, Jiangxi, People's Republic of China.
Queen Mary College, Nanchang University, Jiangxi, People's Republic of China.
Nat Sci Sleep. 2024 Dec 17;16:2111-2124. doi: 10.2147/NSS.S489288. eCollection 2024.
Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder characterized by recurrent upper airway collapse and obstruction, leading to reduced or absent breathing during sleep, especially rapid eye movement (REM) sleep, and continuous positive airway pressure treatment (CPAP) is often used for treatment of OSA. Sawtooth waves (STWs) are a characteristic of REM sleep.
To examine effects of CPAP treatment on STWs during REM sleep in the OSA patients.
Polysomnographic recordings were performed on 20 moderate-to-severe OSA patients and 16 normal controls, and comparisons of STWs during REM sleep in the OSA patients with and without CPAP treatment (paired -test or Wilcoxon signed-rank test wherever appropriate), and between OSA patients and normal controls (Student's -test or Wilcoxon rank-sum test) were carried out. In addition, linear correlation analyses were used to estimate the relationship of STWs and REM sleep with duration of non-REM (NREM) sleep stage 3 (N3).
The STWs were classified to be apnea/hypopnea associated and not associated (isolated), and the amplitude of the isolated STWs was significantly higher than that of the apnea/hypopnea associated. With CPAP treatment, the percentage of REM sleep with STWs and the amplitude of STWs were significantly increased to the levels, which were not significantly different from those in the normal controls, while the frequency of STWs was not significantly changed. In addition, the total duration of REM sleep and the duration of REM sleep with STWs were both positively correlated with the duration of N3 sleep in the normal controls and the OSA patients with CPAP treatment. Furthermore, CPAP treatment also caused a significant increase in the duration of rapid eye movements in REM sleep.
These findings suggest that there are some interconnections between NREM and REM sleep, and STWs not only represent the quality of REM sleep but also are correlated with N3 sleep.
阻塞性睡眠呼吸暂停（OSA）是最常见的与睡眠相关的呼吸障碍，其特征为反复出现上气道塌陷和阻塞，导致睡眠期间尤其是快速眼动（REM）睡眠期间呼吸减少或停止，持续气道正压通气治疗（CPAP）常用于治疗OSA。锯齿波（STWs）是REM睡眠的一个特征。
研究CPAP治疗对OSA患者REM睡眠期间STWs的影响。
对20例中重度OSA患者和16名正常对照者进行多导睡眠图记录，对接受和未接受CPAP治疗的OSA患者REM睡眠期间的STWs进行比较（适当情况下采用配对t检验或Wilcoxon符号秩检验），并对OSA患者与正常对照者进行比较（学生t检验或Wilcoxon秩和检验）。此外，采用线性相关分析来评估STWs和REM睡眠与非快速眼动（NREM）睡眠3期（N3）持续时间的关系。
STWs被分为与呼吸暂停/低通气相关和不相关（孤立性），孤立性STWs的幅度显著高于与呼吸暂停/低通气相关的STWs。经过CPAP治疗，伴有STWs的REM睡眠百分比和STWs的幅度显著增加至与正常对照者无显著差异的水平，而STWs的频率无显著变化。此外，正常对照者以及接受CPAP治疗的OSA患者中，REM睡眠的总持续时间和伴有STWs的REM睡眠持续时间均与N3睡眠的持续时间呈正相关。此外，CPAP治疗还导致REM睡眠中快速眼动持续时间显著增加。
这些发现表明NREM睡眠和REM睡眠之间存在一些联系，STWs不仅代表REM睡眠的质量，还与N3睡眠相关。
