Kass J E, Akers S M, Bartter T C, Pratter M R
Department of Medicine, Cooper Hospital/University Medical Center, Camden, NJ 08103, USA.
Am J Respir Crit Care Med. 1996 Jul;154(1):167-9. doi: 10.1164/ajrccm.154.1.8680674.
Some patients referred for polysomnography with complaints of excessive daytime sleepiness (EDS) and clinically suspected obstructive sleep apnea (OSA) have a respiratory disturbance index (RDI) < 10. Many would consider these patients not to have OSA. We reviewed 34 such patients to determine whether respiratory disturbances confined primarily to rapid eye movement (REM) sleep correlated with an objective criterion for EDS: a mean sleep latency (MSL) < 10 min. REM-specific events were quantified with indices calculated for REM sleep alone. Univariate linear regression showed that a REM-specific respiratory disturbance index (REM-RDI) and the transient arousal index (TAI) computed for REM sleep (REM-TAI) were associated with a low MSL (R2 = -0.35, p = 0.001; and R2 = -0.27, p = 0.01, respectively). In our subjectively sleepy patients with an overall RDI < 10, a REM-RDI > or = 15 had the highest predictive accuracy (82%) for an MSL < 10 min. Seventeen of the 34 study patients had a REM-RDI > or = 15. Their mean MSL was 8.3 +/- 0.8 min. We conclude that within a group of patients with daytime sleepiness, suspected OSA, and a normal RDI, there may be a subset who have clinically significant REM-specific sleep-disordered breathing.
一些因主诉白天过度嗜睡（EDS）而被转诊进行多导睡眠图检查且临床上怀疑患有阻塞性睡眠呼吸暂停（OSA）的患者，其呼吸紊乱指数（RDI）<10。许多人会认为这些患者没有OSA。我们回顾了34例此类患者，以确定主要局限于快速眼动（REM）睡眠的呼吸紊乱是否与EDS的客观标准相关：平均睡眠潜伏期（MSL）<10分钟。仅针对REM睡眠计算的指数对REM特异性事件进行量化。单变量线性回归显示，REM特异性呼吸紊乱指数（REM-RDI）和针对REM睡眠计算的短暂觉醒指数（TAI）（REM-TAI）与低MSL相关（R2 = -0.35，p = 0.001；以及R2 = -0.27，p = 0.01）。在我们主观嗜睡且总体RDI<10的患者中，REM-RDI≥15对MSL<10分钟具有最高的预测准确性（82%）。34例研究患者中有17例REM-RDI≥15。他们的平均MSL为8.3±0.8分钟。我们得出结论，在一组有白天嗜睡、疑似OSA且RDI正常的患者中，可能存在一部分临床上有显著REM特异性睡眠呼吸障碍的患者。
