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持续气道正压通气对阻塞性睡眠呼吸暂停患者嗜睡程度、睡眠功能质量及电生理听觉反应的影响

Effects of Continuous Positive Airway Pressure on the Degree of Sleepiness, Functional Quality of Sleep, and Electrophysiological Hearing Responses in Individuals with Obstructive Sleep Apnea.

作者信息

Farber Marisa Mizrahi, Silva Liliane Aparecida Fagundes, Lorenzi-Filho Geraldo, Matas Carla Gentile

机构信息

Department of Physical Therapy, Speech-language Pathology, Audiology, and Occupational Therapy, Faculty of Medicine, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.

Department of Cardiopneumology, Sleep Laboratory, Instituto do Coração, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.

出版信息

Sleep Sci. 2025 Jul 7;18(3):e281-e291. doi: 10.1055/s-0045-1809060. eCollection 2025 Sep.

Abstract

INTRODUCTION

Obstructive sleep apnea (OSA) affects nerve impulse transmission in the auditory pathway due to oxygen supply. Continuous positive airway pressure (CPAP) therapy improves oxygen levels, potentially alleviating sleepiness and enhancing central auditory pathway function.

OBJECTIVE

To longitudinally evaluate the effect of CPAP on the degree of sleepiness, functional quality of sleep, and electrophysiological hearing responses of the central auditory pathways of patients with moderate to severe OSA.

MATERIALS AND METHODS

There were 31 adults (21 men and 10 women), aged 20 to 70 years, of which 18 were from the group with and 13 from the one without CPAP. All patients underwent three assessments: the first one performed immediately after CPAP prescription; the second, 3 months later; and the third, 6 months after the initial assessment. The Epworth Sleepiness Scale (ESS), the Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10), auditory brainstem response (ABR), and long-latency auditory evoked potentials (LLAEP) were used for these assessments.

RESULTS

The ESS did not detect any changes in excessive daytime sleepiness levels and the FOSQ-10 showed no improvement in either group. Analysis from ABR revealed a high proportion of altered results in both groups at the three assessment times. During the LLAEP, it was observed that the CPAP group exhibited reduced P2 latencies compared with the non-CPAP group in the second assessment. However, this improvement was not sustained in the subsequent assessment, possibly attributed to OSA-induced damage.

CONCLUSION

Treatment with CPAP for 6 months did not improve the degree of sleepiness, functional quality of sleep, or electrophysiological response of hearing, demonstrating that OSA can irreversibly harm the individual.

摘要

引言

阻塞性睡眠呼吸暂停(OSA)由于氧气供应会影响听觉通路中的神经冲动传递。持续气道正压通气(CPAP)疗法可提高氧气水平,有可能减轻嗜睡并增强中枢听觉通路功能。

目的

纵向评估CPAP对中度至重度OSA患者嗜睡程度、睡眠功能质量以及中枢听觉通路电生理听力反应的影响。

材料与方法

共有31名成年人(21名男性和10名女性),年龄在20至70岁之间,其中18名来自接受CPAP治疗组,13名来自未接受CPAP治疗组。所有患者均接受了三次评估:第一次在CPAP处方后立即进行;第二次在3个月后;第三次在初次评估后6个月。这些评估使用了爱泼华嗜睡量表(ESS)、睡眠问卷-10功能结果量表(FOSQ-10)、听觉脑干反应(ABR)和长潜伏期听觉诱发电位(LLAEP)。

结果

ESS未检测到白天过度嗜睡水平有任何变化,FOSQ-10在两组中均未显示出改善。ABR分析显示,在三次评估时两组中结果改变的比例都很高。在LLAEP期间,观察到在第二次评估中,CPAP组与非CPAP组相比P2潜伏期缩短。然而,在随后的评估中这种改善并未持续,可能归因于OSA引起的损害。

结论

CPAP治疗6个月并未改善嗜睡程度、睡眠功能质量或听力的电生理反应,表明OSA会对个体造成不可逆转的损害。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a76/12440591/bdd75f5e919a/10-1055-s-0045-1809060-i240251-1.jpg

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