Hers V, Liistro G, Dury M, Collard P, Aubert G, Rodenstein D O
Pneumology Unit, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium.
Eur Respir J. 1997 May;10(5):973-6. doi: 10.1183/09031936.97.10050973.
The aim of the present study was to assess whether nasal continuous positive airway pressure (nCPAP) treatment, applied for only a few hours at the beginning of the night, has any residual effect on sleep and breathing during the ensuing hours of unassisted sleep in patients with obstructive sleep apnoea syndrome (OSAS). In 27 patients with newly-diagnosed OSAS, effective nCPAP was applied during the first part of the night and then withdrawn. Polysomnographic parameters after nCPAP withdrawal were compared with those of the corresponding part of the diagnostic polysomnography performed a few days or weeks before and with those of the first part of night on nCPAP. After 255+/-63 (mean+/-SD) min of sleep with normalization of sleep and breathing parameters under nCPAP, there was partial improvement of OSAS severity during the remaining 124+/-56 min of nocturnal sleep without treatment; mean oxygen saturation, desaturation index (equivalent to the apnoea/hypopnoea index) and movement arousal index all improved significantly with respect to the diagnostic night (p=0.001). This improvement was not accounted for by a change in sleep architecture. We conclude that there is an improvement in severity of obstructive sleep apnoea syndrome after only 4 h of nasal continuous positive airway pressure. This carryover effect could explain why a number of patients with obstructive sleep apnoea syndrome apply nasal continuous positive airway pressure for only part of the night or not every night.
本研究的目的是评估在夜间开始时仅应用数小时的经鼻持续气道正压通气（nCPAP）治疗，对阻塞性睡眠呼吸暂停综合征（OSAS）患者在随后无辅助睡眠的数小时内的睡眠和呼吸是否有任何残留影响。在27例新诊断的OSAS患者中，在夜间的第一部分应用有效的nCPAP，然后撤掉。将撤掉nCPAP后的多导睡眠图参数与几天或几周前进行的诊断性多导睡眠图相应部分的参数以及nCPAP治疗时夜间第一部分的参数进行比较。在nCPAP治疗下睡眠和呼吸参数正常化的睡眠持续255±63（均值±标准差）分钟后，在未治疗的夜间剩余124±56分钟内，OSAS严重程度有部分改善；平均血氧饱和度、去饱和指数（相当于呼吸暂停/低通气指数）和运动觉醒指数相对于诊断夜均有显著改善（p = 0.001）。这种改善并非由睡眠结构的改变所致。我们得出结论，仅经鼻持续气道正压通气治疗4小时后，阻塞性睡眠呼吸暂停综合征的严重程度就有所改善。这种残留效应可以解释为什么一些阻塞性睡眠呼吸暂停综合征患者仅在夜间部分时间应用经鼻持续气道正压通气，或者并非每晚都使用。
