Millman R P, Acebo C, Rosenberg C, Carskadon M A
Sleep and Chronobiology Research Laboratory, Department of Psychiatry and Human Behavior, E.P. Bradley Hospital/Brown University, East Providence, RI 02915, USA.
Chest. 1996 Mar;109(3):673-9. doi: 10.1378/chest.109.3.673.
We postulated that nasal occlusion would provide a challenge enabling us to assess factors predisposing development of sleep apnea in older children/adolescents and young adults. Factors of interest included sex, age, body mass index (BMI), tonsillar hypertrophy, and cephalometric measurements.
Sleep and breathing variables were examined and compared for four groups of subjects between one baseline night and one night of nasal occlusion in a sleep research laboratory.
Healthy, normal boys (n=23, mean age=13.3+/-2.1 years), girls (n=22, mean age=13.8+/-1.8 years), men (n=23, mean age=22.2+/-1.5 years), and women (n=24, mean age=22.4+/-1.8 years) were studied.
The following sleep and sleep-related breathing measures showed significant increases in all four groups from baseline to occlusion: percentage of stage 1, number of transient arousals, transient arousal index, apnea index, respiratory disturbance index (RDI), and mean apnea length. No significant relationships were found between occlusion-night RDI and tonsillar size, cephalometric variables, or BMI, either singly or in combination.
Subjects' responses to nasal occlusion varied: most demonstrated a minimal and clinically insignificant increase in RDI; few showed a marked increase in RDI. Significant increases of sleep fragmentation -- even in the absence of frankly disturbed breathing -- indicate that nasal occlusion may secondarily affect waking function if prolonged over a series of nights.
我们推测鼻腔阻塞会带来一项挑战，使我们能够评估大龄儿童/青少年及年轻成年人睡眠呼吸暂停发生发展的易感因素。相关因素包括性别、年龄、体重指数（BMI）、扁桃体肥大及头影测量。
在睡眠研究实验室中，对四组受试者在一个基线夜晚和一个鼻腔阻塞夜晚的睡眠及呼吸变量进行检查并比较。
研究了健康正常的男孩（n = 23，平均年龄 = 13.3±2.1岁）、女孩（n = 22，平均年龄 = 13.8±1.8岁）、男性（n = 23，平均年龄 = 22.2±1.5岁）和女性（n = 24，平均年龄 = 22.4±1.8岁）。
从基线到阻塞状态，以下睡眠及与睡眠相关的呼吸指标在所有四组中均显著增加：1期睡眠百分比、短暂觉醒次数、短暂觉醒指数、呼吸暂停指数、呼吸紊乱指数（RDI）及平均呼吸暂停时长。阻塞夜晚的RDI与扁桃体大小、头影测量变量或BMI之间，无论是单独还是综合分析，均未发现显著相关性。
受试者对鼻腔阻塞的反应各不相同：大多数人RDI仅有极小且临床上无显著意义的增加；少数人RDI有明显增加。睡眠片段化显著增加——即使在无明显呼吸紊乱的情况下——表明如果在一系列夜晚持续存在鼻腔阻塞，可能会继发影响清醒功能。
