Tankéré Pierre, Taillard Jacques, PetitJean Thierry, Le-Cam Pierre, Ricordeau François, Blanchard Margaux, Vanbuis Jade, Nofal Anice, Tamisier Renaud, Peter-Derex Laure, Stauffer Emeric
Sleep and Respiratory Medicine, CHU Lyon, Lyon, Auvergne-Rhône-Alpes, France
Laboratoire HP2, Inserm 1042, Université Grenoble Alpes, Saint-Martin-d'Heres, Auvergne-Rhône-Alpes, France.
Thorax. 2025 Mar 18;80(4):245-247. doi: 10.1136/thorax-2024-222462.
The pathophysiology of residual sleepiness in treated obstructive sleep apnoea (OSA) remains poorly understood. Animal models suggest that it may involve neuronal damage due to intermittent hypoxia and sleep fragmentation. In a cohort of 122 continuous positive airway pressure (CPAP) treated OSA patients referred for maintenance of wakefulness test, we explored the determinants of (objective) alertness and those of (subjective) sleepiness assessed by Epworth Sleepiness Scale.We found that in logistic models, residual hypoxic burden was significatively associated with objective impaired alertness (OR=1.005, 95% CI 1.002 to 1.008), p=0.003), whereas arousal index >25/h was significatively associated with subjective residual sleepiness (OR=1.23, 95% CI 1.05to 1.43, p=0.02). This suggests that hypoxia and sleep fragmentation may be involved in different dimensions of residual hypersomnolence in treated OSA.
经治疗的阻塞性睡眠呼吸暂停（OSA）患者残留嗜睡的病理生理机制仍未得到充分了解。动物模型表明，这可能涉及间歇性缺氧和睡眠片段化导致的神经元损伤。在一组122例接受持续气道正压通气（CPAP）治疗的OSA患者中，这些患者被转诊进行清醒维持测试，我们探讨了（客观）警觉性的决定因素以及通过Epworth嗜睡量表评估的（主观）嗜睡的决定因素。我们发现，在逻辑模型中，残余缺氧负担与客观警觉性受损显著相关（比值比=1.005，95%置信区间1.002至1.008，p=0.003），而觉醒指数>25/小时与主观残余嗜睡显著相关（比值比=1.23，95%置信区间1.05至1.43，p=0.02）。这表明缺氧和睡眠片段化可能参与了经治疗的OSA患者残余过度嗜睡的不同方面。
