快速眼动期中各项参数变化对睡眠呼吸暂停综合征评估的意义

Significance of alteration of parameters during rapid eye movement sleep to assess obstructive sleep apnea syndrome

目的:通过测量睡眠呼吸暂停综合征(sleepapneasyndrome,SAS)患者快速眼动期(rapideyemovement,REM)中各项参数的变化,以探讨REM期睡眠各项参数变化对SAS病情严重程度评估的意义。方法:选择1998-10/2002-10本溪钢铁(集团)有限责任公司总医院睡眠疾患诊疗室进行多导睡眠图(polysomnogram,PSG)检查诊断为阻塞型SAS的患者67例,根据呼吸紊乱指数分为轻、中、重度3组,比较各组的各项参数。有34例患者经持续正压气道通气(CPAP)治疗后复查PSG检查。结果:①轻、中、重组REM睡眠时间各占总睡眠时间的(8.98±1.68)%,(5.43±0.86)%,(4.85±0.64)%,中、重度组患者的REM期睡眠时间明显少于轻度组(P<0.05),重度组中REM期睡眠时间较中度组减少,但二者之间差异无显著性意义(P>0.05)。②在中、重度组的阻塞型SAS患者中REM期中的呼吸暂停时间延长及SaO2下降较非REM期明显(P<0.05)。而且心率的变化在3组OSAS患者中REM期中比NREM期中增快明显(P<0.05)。③经CPAP治疗后呼吸紊乱指数、SaO2,REM期及非REM期时间、心率等明显好转(P<0.05)。结论:SAS患者的REM期减少,且在REM期中呼吸暂停时间延长、SaO2降低及心率增快较非REM期更显著。以上变化与阻塞型SAS严重程度有关,CPAP治疗有效。

AIM:To investigate the significance of variation of each parameter during rapid eye movement(REM) sleep in assessing the severity of sleep apnea syndrome(SAS) by measuring the parameter changes of REM sleep in patients with SAS.<METHODS:Totally 67 patients who had been diagnosed with obstructive sleep apnea syndrome(OSAS) by polysomnogram(PSG) were selected from the clinic for those with sleep disorder in General Hospital of Benxi Iron & Steel Group Co.,Ltd from October 1998 to October 2002.The diagnosed patients were divided into mild,moderate and severe groups according to their respiratory disturbance index(RDI),and sleep parameters were compared among the three groups.Of these patients,34 patients would be reexamined by PSG after continuous positive airway pressure(CPAP) treatment.<RESULTS:① The ratio of REM sleeping time to total sleeping time was (8.98± 1.68)% ,(5.43± 0.86)% and (4.85± 0.64)% in the OSAS patients of the mild,moderate and severe groups,accordingly,the REM sleeping time was significantly less in moderate and severe groups than in the mild group(P< 0.05),and less in the severe group than in the moderate group,but without significant differeence between them(P >0.05).② The apnea time prolonged more significantly and SaO2 decreased more significantly during REM than those during nonrapid eye movement(NREM) in the OSAS patients of severe and moderate groups(P< 0.05).Also,heart rate increased more significantly during REM than during NREM(P< 0.05).③ After CPAP treatment,RDI,SaO2 and heart rate were improved greatly,REM sleeping time was prolonged and NREM sleeping time was shortened(P< 0.05).<CONCLUSION:REM sleeping time of patients with SAS decreased,apnea time prolonged,SaO2 decreased and heart rate increased during REM are more significantly than those during NREM.All of the above changes are correlated with the severity of OSAS,and CPAP is effective in treating it.