Hida W, Okabe S, Miki H, Kikuchi Y, Taguchi O, Takishima T, Shirato K
First Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
Thorax. 1994 May;49(5):446-52. doi: 10.1136/thx.49.5.446.
It has previously been reported that short term submental stimulation can reduce the frequency of apnoea and improve sleep architecture in patients with obstructive sleep apnoea. The effects of submental stimulation during consecutive nights on apnoea or on daytime sleepiness have not, however, been studied.
Patients with obstructive sleep apnoea were studied by polysomnography on a control night, for five consecutive nights of submental stimulation, and on three following nights (n = 8). A multiple sleep latency test (MSLT) (n = 8) and measurement of the upper airway resistance (n = 5) were performed during the day after the polysomnographic study, on the control night, and on the fifth stimulation night. In an additional five patients with obstructive sleep apnoea, matched for age, sex, and weight, the effects of two nights of stimulation were examined for comparison. Submental stimulation began when an apnoea lasted for five seconds and stopped with the resumption of breathing as detected by oronasal flow.
The apnoea index, the number of times per hour that SaO2 dropped below 85% (SaO2 < 85%/hour), and the total apnoea duration expressed as a percentage of total sleep time during stimulation nights decreased to approximately 50% of the corresponding values on the control night. This improvement persisted for at least two nights after the five consecutive stimulation nights, but not after the two consecutive stimulation nights. Sleep architecture and MSLT following the stimulation nights improved but upper airway resistance did not change.
Submental stimulation for five consecutive nights in patients with obstructive sleep apnoea improved the breathing disturbance, sleep quality, and daytime sleepiness. The effect lasted for the following two nights, but did not completely abolish the sleep disordered breathing.
此前有报道称，短期颏下刺激可减少阻塞性睡眠呼吸暂停患者的呼吸暂停频率并改善睡眠结构。然而，连续多晚进行颏下刺激对呼吸暂停或日间嗜睡的影响尚未得到研究。
对阻塞性睡眠呼吸暂停患者进行多导睡眠监测，分别在对照夜、连续五个晚上进行颏下刺激以及随后三个晚上（n = 8）。在多导睡眠监测研究后的白天、对照夜以及第五个刺激夜进行多次睡眠潜伏期试验（MSLT）（n = 8）和上气道阻力测量（n = 5）。另外选取五名年龄、性别和体重匹配的阻塞性睡眠呼吸暂停患者，检查两晚刺激的效果以作比较。当呼吸暂停持续五秒时开始颏下刺激，当口鼻气流检测到呼吸恢复时停止刺激。
在刺激夜，呼吸暂停指数、每小时血氧饱和度（SaO2）降至85%以下的次数（SaO2 < 85%/小时）以及总呼吸暂停持续时间占总睡眠时间的百分比降至对照夜相应值的约50%。这种改善在连续五个刺激夜后至少持续两晚，但在连续两个刺激夜后未持续。刺激夜后的睡眠结构和MSLT有所改善，但上气道阻力未改变。
阻塞性睡眠呼吸暂停患者连续五个晚上进行颏下刺激可改善呼吸紊乱、睡眠质量和日间嗜睡。这种效果持续了接下来的两个晚上，但并未完全消除睡眠呼吸障碍。
