成年阻塞性睡眠呼吸暂停患者多导睡眠图及临床特征分析性差异

Polysomnographic findings and clinical presentation of adult men with obstructive sleep apnea

目的:分析成年男性阻塞性睡眠呼吸暂停(OSA)患者多导睡眠图及临床特征,明确年龄对OSA严重程度的影响。方法:回顾性研究包括836名成年男性OSA患者,按年龄分为三组:青年组312人(平均年龄37.07岁),中年组359人(平均年龄52.14岁),老年组165人(平均年龄69.43岁)。分析其多导睡眠图和临床特征,并进行相关性分析。结果:中年组和老年组呼吸暂停低通气指数(AHI)、阻塞性呼吸暂停指数(OAI)、AHI-NREM和AHI-REM均无显著统计学意义(P>0.05),但均低于青年组(P<0.01);中年组和老年组的最低血氧饱和度(SaO2)均高于青年组;中枢性呼吸暂停指数(CAI)随年龄增长而升高(P<0.05)。在睡眠结构方面,老年组总睡眠时间、非快速眼动(NREM)睡眠时间和快速眼动期(REM)睡眠时间均缩短,睡眠效率亦低于青年组(P<0.01),但睡眠潜伏期和入睡后觉醒时间(WASO)明显延长(P<0.01)。年龄与以下各项均呈现显著的相关性:AHI(P<0.01),OAI(P<0.01),CAI(P<0.01),最低SaO2(P<0.01)。多重回归分析表明年龄作为独立变量分别与AHI,OAI,CAI具有相关性。结论:在成年OSA患者中,年龄与OSA严重程度具有显著的相关性,表现为OSA随年龄增长而降低。本研究为研究年龄与OSA严重程度的关系提供了新的证据。

AlM： To determine the age-related differences in the polysomnography （PSG） and clinical presentation of Chinese male adult subjects with obstructive sleep apnea （OSA）, and attempt to identify the age-specific effects on the severity of sleep apnea. METHODS： This retrospective study included a cohort of 836 Chinese male adult subjects, who were diagnosed with OSA by the initial overnight PSG and recruited from the clinic population. The eligible subjects were classified into three different age groups： 312 young （ mean 37. 07 years）, 359 middle-aged （mean 52.14 years） and 165 older （mean 69.43 years）, and their polysomnographic findings and clinical presentation were assessed for the age-specific differences. RESULTS： The AHI-TST between the middle-aged and older subjects was similar （P 〉 0.05）, but less severe than the young （ P 〈 0.01）. This trend was also observed in obstructive Al, AHI-NREM, and AHI-REM. The minimum SaO2 was higher in middle-aged and older subjects than in the young ones （P 〈 0.01）. Central Al became greater following age increase （ P 〈 0.05）. In sleep architecture, the elderly had lower total sleep time, sleep duration NREM or REM, and sleep efficiency than the younger （ P 〈 0. 01 ）, whereas sleep latency and WASO became longer （ P 〈 0. 0l ）. Across all study population, age significantly correlated with AHI （P〈0.01）, obstructive Al （P〈0.01）, central Al （P〈 0.01） and minimum SaO2 （ P 〈 0.01 ）. Multiple regression analyses identified that age as an independent variable associated with AHI, obstructive Al and central Al respectively, after adjusting for confounding factors. CONCLUSION： In Chinese clinic subjects with OSA, age as an independent predictor associates with sleep apnea severity, presenting as decreased OSA and increased CSA with age.