简化醒觉维持试验对日间嗜睡的诊断价值

Evaluation of a simplified maintenance of wakefulness test for the diagnosis of daytime sleepiness

目的 评价简化醒觉维持 (OSLER)试验对诊断日间嗜睡的价值。方法 对 74例打鼾患者用OSLER测定其醒觉维持时间 (OSLER T) ,同时记录Epworth嗜睡评分 (ESS)。患者经过简化睡眠多导系统检查后 ,根据其血氧饱和度下降率 (diprate)的结果将其分成单纯打鼾组 (打鼾组 ,4 3例 )和阻塞性睡眠呼吸暂停低通气综合征组 (OSAHS组 ,31例 )。OSAHS组患者接受气道持续正压通气(CPAP)治疗 ,2个月后再进行OSLER测定。结果 OSAHS组的OSLER T明显比打鼾组短 ,分别为(16 0 3± 12 2 7)min及 (2 5 70± 14 6 2 )min ,P <0 0 1。OSLER T与ESS呈显著的负相关 ,相关系数 (r)为- 0 4 5 ,P <0 0 1。 2 5例OSAHS患者接受 2个月的CPAP治疗后 ,OSLER T从治疗前的 (16 2 0± 12 98)min显著延长至 (36 38± 2 1 10 )min ,P <0 0 1。结论 对打鼾伴 (或不伴 )有OSAHS患者 ,OSLER试验是诊断其日间嗜睡情况的有价值的指标。

Objective The purpose of this study was to assess a simplified maintenance of wakefulness test(Oxford SLEep Resistance test,OSLER test) in evaluating excessive daytime sleepiness Methods Seventy four snorers with or without obstructive sleep apnea hypopnea syndrome(OSAHS) were studied Two OSLER tests were performed in the afternoon with a gap of 30 minutes Epworth sleepiness scale(ESS) was also recorded An overnight sleep study using a multi channel system was performed to distinguish nonapneic snorers(snorer group, n =43) from OSAHS patients(OSAHS group, n =31) The OSLER test was repeated in the OSAHS group after two month treatment with nasal continuous positive airway pressure(CPAP) Results There was a significant difference in sleep latency measured by the OSLER test between the OSAHS group and the snorer group(16 03±12 27 vs 25 70±14 62, P <0 01) A significant correlation was found between sleep latency and ESS( r =-0 45, P <0 01) Twenty five of the 31 patients in the OSAHS group were treated with CPAP for two months Sleep latency increased from 16 20±12 98 to 36 38±21 10 after treatment( P <0 01) Conclusion The OSLER test appears useful in assessing excessive daytime sleepiness