Hoffstein V, Chan C K, Slutsky A S
Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.
Chest. 1993 Jun;103(6):1860-2. doi: 10.1378/chest.103.6.1860.
Left-handedness is associated with shorter life span. Many of the factors contributing to this higher mortality (eg, alcohol consumption, automobile accident, smoking) are the same as in patients with sleep apnea, who also have higher mortality than nonapneic controls. The authors hypothesized that (1) there is a higher prevalence of sinistrality in patients suspected of having sleep apnea than in the general population, and (2) left-handed persons with sleep apnea have a more severe disorder than right-handed ones. These hypotheses were tested in a prospective cohort of 970 patients referred to a sleep disorders center because of suspected sleep apnea. All patients underwent nocturnal polysomnography and measurements of blood pressure. Sixty-one patients were left-handed. The distribution of handedness as a function of age in this cohort was similar to that in the general population. There were 486 patients with an apnea/hypopnea index greater than 10; of these, 34 were left-handed, and 452 were right-handed. Oxygen saturation, blood pressure, age, smoking history, and body mass index were similar in both groups. Left-handed patients with sleep apnea had a significantly higher respiratory disturbance index (RDI) than the right-handed ones (52 +/- 30 vs 38 +/- 35 [p < 0.005]). Right-handed patients were distributed equally among RDI quartiles, but 41 percent of the left-handed patients were within the highest RDI quartile, compared to 12 percent within the lowest quartile. Sinistrality appears to be associated with more severe sleep apnea, which may help to explain the higher mortality seen among the left-handed persons.
左利手与较短的寿命相关。导致这种较高死亡率的许多因素(如饮酒、车祸、吸烟)与睡眠呼吸暂停患者相同,而睡眠呼吸暂停患者的死亡率也高于无呼吸暂停的对照组。作者推测:(1)疑似睡眠呼吸暂停的患者中左利手的患病率高于普通人群;(2)患有睡眠呼吸暂停的左利手患者比右利手患者的病情更严重。在一个因疑似睡眠呼吸暂停而被转诊至睡眠障碍中心的970例患者的前瞻性队列中对这些假设进行了检验。所有患者均接受了夜间多导睡眠图检查和血压测量。其中61例患者为左利手。该队列中利手分布随年龄的变化与普通人群相似。有486例患者的呼吸暂停/低通气指数大于10;其中,34例为左利手,452例为右利手。两组患者的血氧饱和度、血压、年龄、吸烟史和体重指数相似。患有睡眠呼吸暂停的左利手患者的呼吸紊乱指数(RDI)显著高于右利手患者(52±30对38±35 [p<0.005])。右利手患者在RDI四分位数中分布均匀,但41%的左利手患者处于最高RDI四分位数,而处于最低四分位数的仅为12%。左利手似乎与更严重的睡眠呼吸暂停有关,这可能有助于解释左利手人群中较高的死亡率。