Han Teng, Xiang Bo Yun, Liu Ze Long, Guo Xin Rui, Mao Lu Si, Liu Xin, Li Yi Ming, Zhang Xiao Lei
Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
National Center for Respiratory Medicine, Beijing, China.
Sleep Breath. 2025 Jan 13;29(1):75. doi: 10.1007/s11325-025-03251-0.
There is no satisfactory treatment for obstructive sleep apnea (OSA) in patients with interstitial lung disease (ILD) because of poor tolerance of positive airway pressure (PAP) therapy. Supplemental oxygen therapy has been shown to reduce hypoxemia and is well tolerated in patients with ILD. However, little is known about the effect of nocturnal oxygen supplementation (NOS) on OSA in patients with ILD. In this study, we evaluated one night of oxygen therapy in ILD patients with OSA.
Forty-one patients with fibrotic ILD and OSA were randomized to receive supplemental oxygen or air for one night each in a crossover design separated by a washout period of one week. Polysomnography was performed, and sleep-disordered breathing, nocturnal desaturation, sleep architecture, and cardiovascular reactions were monitored.
During nights with sham oxygen, the median (interquartile range) apnea-hypopnea index (AHI) was 14.1/h (10.4/h-24.1/h). The percentage of patients in the N3 sleep stage (N3%) was 19.5% (14.0-31.2%). NOS significantly decreased the AHI by a median of 9.3/h (95% CI, 7.6/h-14.4/h; P < 0.001), increased N3% by 4.4% (95% CI, 0.3-10.1%; P = 0.049), and lowered the sleep stage change index by 1.6/h (95% CI, 0.0/h-4.8/h; P = 0.036). NOS improved the oxygen desaturation index (ODI) by -8.8/h (95% CI, -13.4/h to -5.9/h; P < 0.001) and the mean SpO by 3.0% (95% CI, 2.6-4.5%; P < 0.001). The mean heart rate during sleep was reduced with the NOS; however, total sleep time and nocturnal blood pressure did not change.
In patients with OSA and ILD, one night of oxygen therapy significantly improved sleep-disordered breathing, sleep architecture, nocturnal oxygenation, and heart rate. NOS may be a therapeutic option for ILD patients with OSA.
由于间质性肺疾病（ILD）患者对气道正压通气（PAP）治疗耐受性差，目前尚无令人满意的阻塞性睡眠呼吸暂停（OSA）治疗方法。补充氧气疗法已被证明可减轻低氧血症，且ILD患者耐受性良好。然而，关于夜间补充氧气（NOS）对ILD患者OSA的影响知之甚少。在本研究中，我们评估了对患有OSA的ILD患者进行一晚的氧气治疗效果。
41例患有纤维化ILD和OSA的患者被随机分组，在交叉设计中分别接受一晚的补充氧气或空气治疗，两组治疗间隔一周洗脱期。进行多导睡眠图监测，并监测睡眠呼吸紊乱、夜间血氧饱和度下降、睡眠结构和心血管反应。
在假吸氧的夜晚，呼吸暂停低通气指数（AHI）的中位数（四分位间距）为14.1次/小时（10.4次/小时 - 24.1次/小时）。处于N3睡眠阶段的患者百分比（N3%）为19.5%（14.0 - 31.2%）。NOS使AHI显著降低，中位数为9.3次/小时（95%可信区间，7.6次/小时 - 14.4次/小时；P < 0.001），使N3%增加4.4%（95%可信区间，0.3 - 10.1%；P = 0.049），并使睡眠阶段变化指数降低1.6次/小时（95%可信区间，0.0次/小时 - 4.8次/小时；P = 0.036）。NOS使氧饱和度下降指数（ODI）改善 - 8.8次/小时（95%可信区间， - 13.4次/小时至 - 5.9次/小时；P < 0.001），使平均血氧饱和度（SpO）提高3.0%（95%可信区间，2.6 - 4.5%；P < 0.001）。睡眠期间的平均心率在NOS治疗时降低；然而，总睡眠时间和夜间血压没有变化。
对于患有OSA和ILD的患者，一晚的氧气治疗可显著改善睡眠呼吸紊乱、睡眠结构、夜间氧合和心率。NOS可能是患有OSA的ILD患者的一种治疗选择。
