Martin S E, Marshall I, Douglas N J
Department of Medicine, University of Edinburgh, Scotland.
Am J Respir Crit Care Med. 1995 Aug;152(2):721-4. doi: 10.1164/ajrccm.152.2.7633733.
Snoring and sleep apnea are more common in the supine than seated position. We therefore studied the effect of posture on upper-airway caliber in normal subjects, snorers, and subjects with the sleep-apnea/hypopnea syndrome (SAHS). We measured upper-airway cross-sectional area by acoustic reflection in 110 SAHS patients (apnea/hypopnea index [AHI] > 15), 70 snorers without SAHS (AHI < 15), and 40 male controls matched for body-mass index (BMI) to the 40 SAHS patients. SAHS patients in the seated position had smaller upper-airway areas at the orophyngeal junction (OPJ) than either the snorers (p < 0.01) or the normal subjects (p < 0.02), but there were no differences between groups in airway cross-sectional areas in the supine or lateral recumbent positions. SAHS patients had significantly smaller decreases in OPJ area from the seated to either the supine (p < 0.001) or lateral recumbent (p < 0.001) positions than did the snorers. SAHS patients also had smaller (p < 0.05) decreases in OPJ area upon lying down than did the BMI-matched normal subjects. These data are compatible with SAHS patients defending their upper airway more upon lying down than do snorers or normal subjects.
打鼾和睡眠呼吸暂停在仰卧位比坐位更常见。因此，我们研究了姿势对正常受试者、打鼾者和患有睡眠呼吸暂停/低通气综合征（SAHS）的受试者上气道口径的影响。我们通过声反射测量了110例SAHS患者（呼吸暂停/低通气指数[AHI]>15）、70例无SAHS的打鼾者（AHI<15）以及40例与40例SAHS患者体重指数（BMI）匹配的男性对照者的上气道横截面积。坐位的SAHS患者在口咽交界处（OPJ）的上气道面积比打鼾者（p<0.01）和正常受试者（p<0.02）都小，但在仰卧位或侧卧位时，各组之间的气道横截面积没有差异。与打鼾者相比，SAHS患者从坐位到仰卧位（p<0.001）或侧卧位（p<0.001）时OPJ面积的减小明显更小。与BMI匹配的正常受试者相比，SAHS患者躺下时OPJ面积的减小也更小（p<0.05）。这些数据表明，与打鼾者或正常受试者相比，SAHS患者在躺下时对上气道的保护作用更强。
