Lv Yidi, Ruan Litao, Guo Aihong, Lu Zhaoying, Zhang Guoxun, Lei Xinjun
The Department of Cardiovasology, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, 710061, China.
The Department of Ultrasound, The Third Affiliated Hospital of Yan'an University, Shaanxi, 712000, China.
Sleep Breath. 2025 May 15;29(2):186. doi: 10.1007/s11325-025-03337-9.
Both obstructive sleep apnea (OSA)and patent foramen ovale (PFO) can lead to changes in blood oxygen. However, it is unclear whether PFO exacerbates the blood oxygen indicators of OSA.
This case series study included patients who underwent contrast-enhanced transcranial Doppler (c-TCD) and polysomnography (PSG examination) between January 2017 to December 2023 at the Third Affiliated Hospital of Yan'an University. Based on c-TCD and PSG results, patients were categorized into two groups: OSA and PFO double-positive group (OSA + PFO), OSA single-positive group (OSA). Furthermore, both the OSA + PFO and OSA groups were further subdivided into mild (5 times/hour ≤ AHI < 15 times/hour), moderate (15 times/hour ≤ AHI < 30 times/hour) and severe (AHI ≥ 30 times/hour) groups according to their apnea-hypopnea index (AHI). This study compared the minimum oxygen saturation, oxygen desaturation index (ODI), the percentage of cumulative time with oxygen saturation < 90% in total sleep time (T90) among all groups.
A total of 509 patients were included (386 males,75.83%; 123females,24.17%), with an average age of 56.76 ± 10.23 years. The study cohort included 97 OSA + PFO cases (55.67% moderate to severe) and 412 OSA cases (63.35% moderate to severe). No significant differences were observed in minimum oxygen saturation (75.97 ± 12.70% vs. 76.34 ± 12.67%, respectively, P =0.607) and ODI (32.99 ± 24.16% vs. 34.31 ± 23.59%, respectively, P =0.173) between the OSA group and the OSA + PFO group. Similarly, no significant differences were found in T90 (14.20 ± 20.50% vs. 16.69 ± 21.62%, respectively, P =0.075) between the OSA group and the OSA + PFO group. However, the T90 values were significantly higher in the moderate-severe OSA + PFO group compared to the moderate-severe OSA group (26.21 ± 22.97% vs.18.68 ± 22.02%, respectively, P < 0.05).
Although PFO has no significant effect on minimum oxygen saturation and ODI, PFO further aggravates intermittent hypoxia in patients with moderate to severe OSA.
阻塞性睡眠呼吸暂停（OSA）和卵圆孔未闭（PFO）均可导致血氧变化。然而，PFO是否会加重OSA的血氧指标尚不清楚。
本病例系列研究纳入了2017年1月至2023年12月在延安大学第三附属医院接受经颅多普勒超声造影（c-TCD）和多导睡眠图（PSG检查）的患者。根据c-TCD和PSG结果，将患者分为两组：OSA和PFO双阳性组（OSA+PFO）、OSA单阳性组（OSA）。此外，OSA+PFO组和OSA组均根据呼吸暂停低通气指数（AHI）进一步分为轻度（5次/小时≤AHI＜15次/小时）、中度（15次/小时≤AHI＜30次/小时）和重度（AHI≥30次/小时）组。本研究比较了所有组的最低血氧饱和度、血氧饱和度下降指数（ODI）、总睡眠时间中血氧饱和度＜90%的累计时间百分比（T90）。
共纳入509例患者（男性386例，占75.83%；女性123例，占24.17%），平均年龄56.76±10.23岁。研究队列包括97例OSA+PFO病例（55.67%为中度至重度）和412例OSA病例（63.35%为中度至重度）。OSA组和OSA+PFO组之间在最低血氧饱和度（分别为75.97±12.70%和76.34±12.67%，P=0.607）和ODI（分别为32.99±24.16%和34.31±23.59%，P=0.173）方面未观察到显著差异。同样，OSA组和OSA+PFO组之间在T90方面也未发现显著差异（分别为14.20±20.50%和16.69±21.62%，P=0.075）。然而，中度至重度OSA+PFO组的T90值显著高于中度至重度OSA组（分别为26.21±22.97%和18.68±22.02%，P＜0.05）。
虽然PFO对最低血氧饱和度和ODI无显著影响，但PFO会进一步加重中度至重度OSA患者的间歇性缺氧。
