体位改变对OSAHS患者过度日间嗜睡的影响及相关性分析

张欣; 徐彧; 王成禹; 李佩忠

doi:10.13201/j.issn.1001-1781.2018.18.013

体位改变对OSAHS患者过度日间嗜睡的影响及相关性分析

- 南京医科大学附属淮安第一医院耳鼻咽喉科(江苏淮安, 223300)

详细信息

通讯作者: 张欣,E-mail:suk0417@126.com

中图分类号: R563.8

收稿日期: 2018-07-09

Effects of sleep body posture on subjective sleepiness in patients with OSAHS

- Department of Otorhinolaryngology, the Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, 223300, China

More Information

Corresponding author: ZHANG Xin, E-mail: suk0417@126.com

Received Date: 09 July 2018

摘要

摘要: 目的：研究体位改变对OSAHS患者日间嗜睡的影响及相关性分析。方法：对90例OSAHS患者行Epworth嗜睡量表嗜睡量表评分（ESS）并按呼吸暂停低通气指数（AHI）分为轻度OSAHS组（5 ≤ AHI<15）、中度OSAHS组（15 ≤ AHI<30）和重度OSAHS组（AHI ≥ 30），比较体位改变对不同程度OSAHS患者日间嗜睡的影响。结果：由仰卧位变换为侧卧位时，3组微觉醒指数差异、夜间最低血氧饱和度（MinSpO₂）、REM睡眠占总睡眠时间的百分率（REM%）及NREM睡眠占总睡眠时间的百分率（NREM%）均差异有统计学意义（F=12.10、43.67、15.81、13.17，均P<0.05）；与仰卧位相比，OSAHS重度组侧卧位时MinSpO₂、REM%及NREM%差异有统计学意义（t=3.02、2.41、2.90，均P<0.05）。仰卧位呼吸暂停指数（S-AHI）、侧卧位呼吸暂停指数（L-AHI）与OSAHS轻、中度组ESS评分无相关性（P>0.05），而L-AHI与OSAHS重度组ESS评分显著相关（r=0.454，P<0.01）；REM L-AHI和NREM L-AHI与OSAHS重度组ESS评分显著相关（r=0.522，P<0.01；r=0.425，P<0.001）。结论：睡眠体位改变对重度OSAHS组的睡眠结构、呼吸事件有显著的影响，与S-AHI相比，L-AHI更能反映重度OSAHS患者日间嗜睡严重程度。
- 睡眠呼吸暂停低通气综合征,阻塞性 /
- 睡眠体位 /
- 多次睡眠潜伏期试验 /
- 体位呼吸暂停指数
Abstract: Objective: To observe the effects of sleep body posture on subjective sleepiness in patients with OSAHS.Method: We assessed the sleeping body position, the sleep structure, position specific AHI and the Epworth Sleepiness Scale (ESS) in a total of 90 patients with OSAHS. The patients were grouped according to AHI:mild OSAHS (5 ≤ AHI<15), moderate (15 ≤ AHI<30) and severe (AHI ≥ 30). The polysomnography data and clinical characteristics were compared between each group.Result: There was statistically significant difference in arousal index,MinSpO₂,REM% and NREM% among three groups (F value was 12.10,43.67,15.81,13.17,respectively,P<0.05). Compared with supine,the severe OSAHS group had significantly bigger changes in MinSpO₂, REM% and NREM%(t value was 3.02,2.41,2.90,respectively,P<0.05). For mild-to-moderate groups,there was no correlation between the ESS and the AHI at any position(P>0.05). For severe group,the ESS was significantly correlated with L-AHI(r=0.454,P<0.01);the REM L-AHI and NREM L-AHI was also significantly correlated with ESS of severe group (r=0.522 and 0.425,P<0.01). Conclusion: The sleep body posture had significant effects on sleep structure and respiratory events in severe OSAHS group. The L-AHI was found to have a closer association with daytime sleepiness in severe OSAHS than other groups.
- sleep apnea hypopnea syndrome, obstructive /
- sleeping position /
- multiple sleep latency test /
- position specific apnea-hypopnea index

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