Li Hongguang, Zhang Bowen, Liao Jianhong, Shi Yunhan, Li Yanru
Department of Otolaryngology Head and Neck Surgery，Beijing Tongren Hospital，Capital Medical University，Key Laboratory of Otolaryngology Head and Neck Surgery（Capital Medical University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jan;39(1):42-46. doi: 10.13201/j.issn.2096-7993.2025.01.009.
The variability of the apnea-hypopnea index（AHI） measured in the first and second halves of the night is significant in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）. This variation may be related to fluid redistribution caused by the supine position during sleep. Eighty-nine adult subjects were enrolled. Circumferences（neck, chest, waist, and calf） were measured before sleep onset and upon awakening. Polysomnography（PSG） was performed, and the night was divided into two halves based on the midpoint of total sleep time to calculate AHI for each half. The correlation between changes in AHI and changes in circumferences was analyzed. Twenty simple snorers and sixty-nine OSAHS patients were included, with a median AHI of 22.6（11.8, 47.3） events/hour. Compared to pre-sleep measurements, there was no significant change in neck circumference upon awakening in the control group（=0.073）, while reductions were observed in the other three measurements（=0.006, =0.038, <0.001）. In the OSAHS group, neck circumference increased（<0.001）, and reductions were noted in the other three measurements（<0.001 for all）, with the most significant change observed in calf circumference 40.0（37.1, 42.0） cm to 38.0（35.8, 40.5） cm. Compared to the first half of the night, total AHI, supine AHI, and NREM AHI significantly decreased in the second half（=0.010, =0.031, =0.001）, while no significant changes were observed in lateral AHI and REM AHI（=0.988, =0.530）. Further analysis revealed a significant relationship between increased chest circumference and decreases in NREM AHI, supine AHI, and supine NREM AHI（=0.036, =0.072, =0.034）, as well as between decreased lateral position AHI and increased waist circumference（=0.048）. Additionally, this study found a negative correlation between changes in calf circumference and changes in AHI（=-0.24, =0.048）, while neck circumference changes positively correlated with changes in AHI（=0.26, =0.03）. In OSAHS patients during the second half of sleep compared to before sleeping, chest circumference, waist circumference, and calf circumference decrease while neck circumference increases; total AHI, supine position AHI, and NREM period AHI decrease; increases in chest circumference are associated with decreases in NREM period AHI, supine position AHI, supine position NREM period AHI. There is nocturnal variability in AHI among OSAHS patients that may be associated with fluid shifts during sleep.
在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者中，夜间前半段和后半段测量的呼吸暂停低通气指数（AHI）变异性显著。这种变化可能与睡眠期间仰卧位导致的液体重新分布有关。招募了89名成年受试者。在入睡前后测量了（颈部、胸部、腰部和小腿）周长。进行了多导睡眠图（PSG）检查，并根据总睡眠时间的中点将夜间分为两半，以计算每半段的AHI。分析了AHI变化与周长变化之间的相关性。纳入了20名单纯打鼾者和69名OSAHS患者，AHI中位数为22.6（11.8，47.3）次/小时。与睡前测量相比，对照组醒来时颈部周长无显著变化（=0.073），而其他三项测量值均降低（=0.006，=0.038，<0.001）。在OSAHS组中，颈部周长增加（<0.001），其他三项测量值降低（均<0.0着仰卧位AHI和NREM AHI显著降低（=0.010，=0.031，=0.001），而侧卧位AHI和REM AHI无显著变化（=0.988，=0.530）。进一步分析显示，胸围增加与NREM AHI、仰卧位AHI和仰卧位NREM AHI降低之间存在显著关系（=0.036，=0.072，=0.034），以及侧卧位AHI降低与腰围增加之间存在显著关系（=0.048）。此外，本研究发现小腿周长变化与AHI变化之间存在负相关（=-0.24，=0.048），而颈部周长变化与AHI变化呈正相关（=0.26，=0.03）。与睡前相比，OSAHS患者睡眠后半段的胸围、腰围和小腿围减小，而颈部围增加；总AHI、仰卧位AHI和NREM期AHI降低；胸围增加与NREM期AHI、仰卧位AHI、仰卧位NREM期AHI降低有关。OSAHS患者的AHI存在夜间变异性，这可能与睡眠期间的液体转移有关。 01），而其他三项测量值（均<0.001）降低，小腿围变化最为显著，从40.0（37.1，42.0）cm降至38.0（35.8，40.5）cm。与夜间前半段相比，后半段总AHI、仰卧位AHI和NREM AHI显著降低（=0.010，=0.031，=0.001），而侧卧位AHI和REM AHI无显著变化（=0.988，=0.530）。进一步分析显示，胸围增加与NREM AHI、仰卧位AHI和仰卧位NREM AHI降低之间存在显著关系（=0.036，=0.072，=0.034），以及侧卧位AHI降低与腰围增加之间存在显著关系（=0.048）。此外，本研究发现小腿周长变化与AHI变化之间存在负相关（=-0.24，=0.048），而颈部周长变化与AHI变化呈正相关（=0.26，=0.03）。与睡前相比，OSAHS患者睡眠后半段的胸围、腰围和小腿围减小，而颈部围增加；总AHI、仰卧位AHI和NREM期AHI降低；胸围增加与NREM期AHI、仰卧位AHI、仰卧位NREM期AHI降低有关。OSAHS患者的AHI存在夜间变异性，这可能与睡眠期间的液体转移有关。
