Ancoli-Israel S, Engler R L, Friedman P J, Klauber M R, Ross P A, Kripke D F
Department of Psychiatry, University of California, San Diego.
Chest. 1994 Sep;106(3):780-6. doi: 10.1378/chest.106.3.780.
This study was designed to determine the impact of central sleep apnea with or without Cheyne-Stokes respiration (CSR) on morbidity and mortality. Central sleep apnea was found in 77 male general medical ward in-patients. Cheyne-Stokes respiration was found in 49 of the 77 men; in 15 men, CSR was severe, ie, > or = 25 percent of the night spent in CSR, in 34 men CSR was mild (1 to 25 percent CSR). Twenty-eight men had central sleep apnea but no CSR. An additional 31 patients had no sleep apnea and no CSR. The patients with severe CSR had more central apneas, more, but shorter desaturations, more awakenings and more wake time during the night, but spent more time in bed than those with no CSR or no apnea. Radiographic evidence was consistent with an association of CSR and heart failure. In addition, patients with severe CSR were at almost twice the risk of dying compared with those with no apnea and had a shorter survival time. Nevertheless, we could not confirm that CSR was an independent predictor of elevated mortality risk, implying that some other factors specific to severe CSR predispose these patients to shorter survival time.
本研究旨在确定伴或不伴陈-施呼吸（CSR）的中枢性睡眠呼吸暂停对发病率和死亡率的影响。在77名男性普通内科病房住院患者中发现了中枢性睡眠呼吸暂停。77名男性中有49名存在陈-施呼吸；其中15名男性的陈-施呼吸严重，即夜间陈-施呼吸时间占比≥25%，34名男性的陈-施呼吸为轻度（陈-施呼吸时间占比1%至25%）。28名男性有中枢性睡眠呼吸暂停但无陈-施呼吸。另外31名患者既无睡眠呼吸暂停也无陈-施呼吸。与无陈-施呼吸或无睡眠呼吸暂停的患者相比，严重陈-施呼吸的患者夜间中枢性呼吸暂停更多、血氧饱和度下降更多但持续时间更短、觉醒更多、清醒时间更长，不过卧床时间也更多。影像学证据显示陈-施呼吸与心力衰竭有关。此外，与无睡眠呼吸暂停的患者相比，严重陈-施呼吸的患者死亡风险几乎高出一倍，生存时间更短。然而，我们无法证实陈-施呼吸是死亡率升高的独立预测因素，这意味着严重陈-施呼吸特有的其他一些因素使这些患者的生存时间缩短。
