阻塞性睡眠呼吸暂停低通气综合征患者睡眠结构研究

Sleeping structure in patients with obstructive sleep apnea-hypopnea syndrome

目的研究阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea-Hypopnea Syndrome,OSAHS)患者的睡眠结构改变并探讨其临床意义。方法在纳入研究的108例患者中,经多导睡眠图(PSG)检查确诊OSAHS患者81例,其中轻度、中度以及重度组分别27例,对照组(单纯鼾症组)27例,比较各组觉醒时间、非快速眼动(NREM)、快速眼动(REM)睡眠各期所占比例计算其百分比;比较各组呼吸暂停低通气指数(apnea-hypopnea index,AHI)、体质指数(BMI)、微觉醒指数(MI,次/h)的差别;对各组AHI与S3+S4期睡眠百分比、MI的相关性进行分析。结果各OSAHS组觉醒时间、S2、S3+S4期睡眠、REM期睡眠均显著高于单纯鼾症对照组(P<0.05);S1期睡眠重度OSAHS组显著高于对照组(P<0.05),轻、中度OSAHS组和对照组差异不具有显著性(P>0.05);MI中、重度OSAHS组显著高于对照组(P<0.05),轻度OSAHS组和对照组差异不具有显著性(P>0.05);各组的AHI与S3+S4期睡眠百分比、MI的Pearson相关系数分别为-0.478和0.785,具有良好的相关性。结论 OSAHS患者觉醒时间增加、深睡眠减少、微觉醒增加,睡眠结构严重紊乱,从而产生白天嗜睡、记忆力下降、智力障碍以及个性改变等一系列脑功能障碍的临床症状。

Objective To investigate the sleep structure in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods 108 patients with snoring during night were diagnosed by polysomnography {PSG） and divided into 4 groups by apnea-hypopnea index {AHI）, including snorer, mild, middle and sever group. There were 27 cases for each group. The percentage of sleep stages of non-rapid eye movement （NREM） and rapid eye movement （REM）, body mass index （BMI） and microarousal index （MI） were analyzed. Results The awaking time was 19.26% ±12.71%, 17.38%±9.05%, 16.76%±11.92% and 7.80%±6.50% for snorer, mild, middle and sever group, respectively. The percentage of S1 was 18. 92%±11.50%, 19. 24%±11. 88%, 41. 88%±12.42% and 15. 88% ± 9. 10%, respectively. $2 was t8.73%±11.68%, 37.92%±12.55%, 35.68±10.71% and 25.91%±8.94%, respectively. S3＋S4 was 39.29%±11.27%, 13.86%±9.71%,15.42%±9.91% and 9. 86%±4. 71%, respectively. The percentage oF REM sleep was 17.8%±9.72%, 10.54% ±8.34%, 11.14%±7.02% and 3.60%±3.77%. MI was 13. 47± 6.53, 18.02 ± 10.21, 32.91±11.73 and 41.88 ± 15.58, respectively. There is negative correlation between S3＋ S4 and AHI and positive correlation between MI and AHI. Conclusion The sleeping structure of patients with OSAHS was impacted. The awaking time, MI increased and stage 3-4 sleep decreased. The sleep fragmentation may cause cerebral dysfunctions in patients with severe OSAHS as day drowsiness, shorter memory, retardation and personality change occur.