Wang Y M, Liu C C, Guo W B, Sun L, Zeng J P, Chen Z Q, Yue H J, Lei W B
Otorhinolaryngology Hospital, The First Affiliated H00ospital, Sun Yat-sen University, Guangzhou Key Laboratory of Otorhinolaryngology, Guangzhou 510080, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Aug 7;60(8):868-874. doi: 10.3760/cma.j.cn115330-20250110-00033.
To analyze the correlation between respiratory event duration and nocturnal oxygen saturation (SpO) in adults with obstructive sleep apnea (OSA), and to explore its significance in assessing nocturnal hypoxemia and OSA severity. A prospective study was conducted on adult OSA patients diagnosed via overnight standard polysomnography (PSG) at the Department of Otolaryngology, First Affiliated Hospital of Sun Yat-sen University from June 2019 to December 2023. Data collected included demographic information, PSG reports, scale scores, and comorbidities. Patients were first stratified by apnea-hypopnea index (AHI) severity. Relationships between respiratory event duration parameters,including total apnea-hypopnea time (TAHT), percentage of total sleep time with apnea-hypopnea (AHT%), total apnea time (TAT), total hypopnea time (THT), and mean apnea-hypopnea time (MAHT), and nocturnal SpO₂ parameters, including average SpO₂ (aSpO₂), minimal SpO₂ (mSpO₂), mean oxygen desaturation (MOD), and percentage of total sleep time with SpO₂<90% (CT90), were analyzed. Patients were then divided into two groups based on the median MAHT (27.6 s) for SpO₂ comparison. Finally, severe OSA patients were further subclassified using an AHI inflection point (50 events/h) identified via scatter plot analysis to compare nocturnal SpO₂. Statistical analysis was performed using SPSS 27.0. Among the 250 study subjects, there were 201 males and 49 females, with ages ranging from 18 to 76 years (mean age: 41.6 ± 11.9 years).TAHT, AHT%, and TAT in OSA patients demonstrated significant negative correlations with aSpO₂(=-0.698, -0.718, -0.646)and mSpO₂(=-0.746, -0.746, -0.748), while showing positive correlations with MOD (=0.783, 0.791, 0.823)and CT90 (=0.868, 0.866, 0.852),<0.05. When stratified by MAHT median (=27.6 s), the "long-event" subgroup (=125) displayed significantly lower mSpO and higher MOD and CT90 compared to the "short-event" subgroup (=125), =-3.319, 3.288, 2.242;<0.05. No significant difference in aSpO was observed (>0.05). Subgrouping severe OSA patients at AHI=50 events/hour revealed significant differences in aSpO, mSpO, MOD, and CT90 between groups (=-5.011, -4.787, 5.142, 6.117, <0.05). TAHT, AHT%, and TAT significantly correlate with nocturnal SpO₂ parameters in OSA patients and can supplement AHI in assessing OSA severity. MAHT independently reflects nocturnal oxygenation status beyond AHI.
分析阻塞性睡眠呼吸暂停（OSA）成年患者呼吸事件持续时间与夜间血氧饱和度（SpO₂）之间的相关性，并探讨其在评估夜间低氧血症和OSA严重程度中的意义。对2019年6月至2023年12月在中山大学附属第一医院耳鼻咽喉科通过夜间标准多导睡眠图（PSG）诊断的成年OSA患者进行了一项前瞻性研究。收集的数据包括人口统计学信息、PSG报告、量表评分和合并症。患者首先按呼吸暂停低通气指数（AHI）严重程度分层。分析呼吸事件持续时间参数，包括总呼吸暂停低通气时间（TAHT）、呼吸暂停低通气占总睡眠时间的百分比（AHT%）、总呼吸暂停时间（TAT）、总低通气时间（THT）和平均呼吸暂停低通气时间（MAHT），与夜间SpO₂参数，包括平均SpO₂（aSpO₂）、最低SpO₂（mSpO₂）、平均氧饱和度下降（MOD）和SpO₂<90%占总睡眠时间的百分比（CT90）之间的关系。然后根据MAHT中位数（27.6秒）将患者分为两组进行SpO₂比较。最后，通过散点图分析确定的AHI拐点（50次事件/小时）对重度OSA患者进行进一步亚组分类以比较夜间SpO₂。使用SPSS 27.0进行统计分析。在250名研究对象中，男性201名，女性49名，年龄范围为18至76岁（平均年龄：41.6±11.9岁）。OSA患者的TAHT、AHT%和TAT与aSpO₂（r=-0.698、-0.718、-0.646）和mSpO₂（r=-0.746、-0.746、-0.748）呈显著负相关，而与MOD（r=0.783、0.791、0.823）和CT90（r=0.868、0.866、0.852）呈正相关，P<0.05。按MAHT中位数（27.6秒）分层时，“长事件”亚组（n=125）与“短事件”亚组（n=125）相比，mSpO₂显著降低，MOD和CT90升高，P=-3.319、3.288、2.242；P<0.05。aSpO₂未观察到显著差异（P>0.05）。将重度OSA患者按AHI=50次事件/小时进行亚组分类显示，两组之间aSpO₂、mSpO₂、MOD和CT90存在显著差异（P=-5.011、-4.787、5.142、6.117，P<0.05）。TAHT、AHT%和TAT与OSA患者夜间SpO₂参数显著相关，可在评估OSA严重程度时补充AHI。MAHT独立于AHI反映夜间氧合状态。
