阻塞性睡眠呼吸暂停低通气综合征患者睡眠时相改变及与呼吸紊乱的关系

The Correlation of Respiratory Disturbance and Sleep Phase in Obstructive Sleep Apnea Hypopnea Syndrome

目的研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠时相改变及与呼吸暂停低通气的关系。方法分析33例多导睡眠仪确诊的OSAHS患者及11例单纯肥胖者的睡眠监测结果,对夜间呼吸暂停、低氧以及睡眠结构的改变进行分析。结果OSAHS组患者紊乱指数、平均觉醒时间、最长暂停时间、觉醒指数、平均血氧和最低血氧、慢波睡眠及REM睡眠百分比与对照组间差异有显著性意义(P<0·01),鼾声指数两组间差异无显著性意义(P>0·05);中、重度OSAHS组患者REM期呼吸暂停次数及时间与NREM期差异有显著性意义(P<0·05);REM睡眠的百分比与AHI呈负相关(r=-0·627)。结论OSAHS患者REM期睡眠时间减少,并与病情明显相关;OS-AHS患者REM期呼吸暂停低通气较NREM期更加严重。

Objective To study the correlation of respiratory disturbance and sleep phase in obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods The results of sleeping monitoring for 33 cases with OSAHS diagnosed by polysomnography （PSG） and 11 cases of pure obesity were analyzed to explore the changes of apnea of sleep, low oxygen and sleep structure. Results Compared with controls, OSAHS patients＇apnea hypopnea index, mean awaking duration, maximal apnea time and awaking index, mean blood oxygen content and minimal blood oxygen, slow wave sleep and rapid eye movement （REM） sleep is significantly different （ P 〈0. 01 ）, but no significant difference was found in snoring index （ P 〉0. 05）. The times and duration of apnea of patients with moderate and sever OSAHS in REM phase were significantly different from those in NREM phase （ P 〈 0. 05 ） ; and the percentage of REM sleep was negatively correlated with apnea hypopnea index （ r = - 0. 627）. Conclusion The OSAHS patients＇REM sleep duration decreases obviously, which is related to their conditions of disease; The sleep apnea hypopnea in REM phase is more serious than in NREM phase.