中重度睡眠呼吸暂停低通气综合征患者白天嗜睡与生活质量的关系

The relationship between excessive daytime sleepiness and the quality of life in patients with moderate to se-vere obstructive sleep apnea and hypoventilation syndrome

目的探讨中重度睡眠呼吸暂停低通气综合征（OSAHS）患者白天过度嗜睡（EDS）程度与生活质量的关系。方法选择多导睡眠图（PSG）确诊的中重度OSAHS患者123例为病例组，同期PSG排除OSAHS的良性打鼾患者52例为对照组。以Epworth嗜睡评分（ESS）量表表示患者EDS程度，Calgary生活质量指数（SAQLI）评价中重度OSAHS患者生活质量，比较两组患者一般资料、PSG结果和SAQLI总分及各项评分。结果中重度OSAHS患者与对照组相比，体质量指数（BMI）、呼吸紊乱指数（RDI）、最低氧饱和度（LSpO2）、最长呼吸暂停时间（Tmax）和氧饱和度低于90％时间占总睡眠时间（T90）、ESS评分和SAQLI总分及各项评分等均存在显著性差异。ESS评分与SAQLI总分及各项评分呈显著相关。结论中重度OSAHS患者存在EDS；中重度OSAHS的EDS与生活质量降低有关；EDS可能在一定程度上反映了中重度OSAHS患者的生活质量下降。

Objective To investigate the association of excessive daytime sleepiness （EDS） and the quality of life in patients with moderate to severe obstructive sleep apnea and hypoventilation syndrome （OSAHS）. Methods 123 patients with moderate to severe OSAHS were diagnosed by polysomnography（PSG）, and 52 cases ruled out by PSG were controls. Patients and controls were completed the Calgary sleep apnea quality of life index （SAQLI） and the Epworth sleepiness score （ESS）. Results There were statistical significance of body mass index （BMI） ,respiratory disturbance index（RDI） ,the lowest oxygen saturation （LSpO2 ）, the longest apnea time （Tmax）, the percentage of recording time with oxygen saturation of 90% or less （T90） between the patients and the controls. Daily Functioning, Social Interactions, Emotional Functioning, Symptoms, and total scores of SAQLI in patients with moderate to severe OSAHS were（3.88 ±1.05） ,（4.48 ±1.39）, （4.76 ± 1.59）, （2.98 ± 1.10）, （3.94 ± 1.22）, which were less than that of controls respectively. The ESS scores of patients with moderate to severe OSAHS were higher than that of controls [ （ 13.98 ± 4.05 ） vs （5.78 ± 2.45 ） ], （ P 〈 0.01 ）. ESS were related to the daily Functio- ning,social interactions,emotional functioning,symptoms,and total scores of SAQLI in patients with moderate to se- vere OSAHS, and the coefficient of correlation were - 0.52, - 0.48, - 0.40, - 0.48 and - 0.44, respectively, and all P value were less than 0.01. Conclusion Patients with moderate to severe OSAHS have the EDS, which associate with the impairment of quality of life. The higher ESS may indicate the decrease of quality of life in patients with mod- erate to severe OSAHS.