睡眠呼吸暂停低通气综合征患者多导睡眠图特征及日间嗜睡分析

Gender differences on polysomnographic findings and daytime sleepiness in subjects with obstructive sleep apnea syndrome

目的 通过对男女睡眠呼吸暂停低通气综合征（OSA）患者多导睡眠图特征及日间嗜睡程度的对比,探究OSA患者的多导睡眠图特征及日间嗜睡程度是否存在性别差异.方法 选取2011年5月～2013年2月在华西医院睡眠中心就诊,年龄在18～65岁之间,经整夜多导睡眠呼吸监测确诊为OSA（睡眠呼吸紊乱指数,AHI≥5次/h）的患者进行回顾性分析.按性别分为男性OSA患者及女性OSA患者两组,并对两组的年龄及AHI进行配对.比较两组患者多导睡眠图所示睡眠结构、缺氧状况、多次小睡潜伏时间试验（MSLT）及Epworth嗜睡量表（ESS）评分的差异.结果 共258名患者纳入研究,其中男性129名,平均年龄（49.4±11.3）岁,平均AHI指数（35.3±26.7）次/h;女性129名,平均年龄（49.7±11.8）岁,平均AHI指数（34.1±26.7）次/h.男女OSA患者相比,女性患者睡眠潜伏期更长[（19.2± 28.1）vs.（12.9±12.9）min],睡眠效率更低[（78.5±14.1）% vs.（84.5±9.7）%],睡后觉醒时间更长[（89.8±63.8）vs.（66.1±48.4）min],总睡眠时间更短[（396.9±78.8）vs.（ 427.6± 56.1）min],多次小睡平均潜伏期更长[（9.9±3.39）vs.（9.3±3.7）min],（P均＜0.05）.男女患者呼吸事件中低通气所占比例[（39.9±26.3）% vs.（53.4±27.7）%],阻塞性呼吸暂停所占比例为[（50.81±25.88）% vs.（41.03±26.72）%],（P均＜0.05）.结论 在AHI严重程度相一致的情况下,女性患者睡眠质量更差,但男性患者日间客观嗜睡程度更重.呼吸事件中女性患者多以低通气为主,而男性患者多以阻塞性呼吸暂停为主.

Objective To evaluate the gender differences in patients with obstructive sleep apnea （OSA） based on poly- somnographic findings and daytime sleepiness. Methods The retrospective evaluation included patients who visited medical sleep center, West China Hospital of Sichuan University from May 2011 to February 2013. They all been diagnosed with OSAS （Ob- structive Sleep Apnea syndrome, Apnea Hyponea Index≥5times/hour）. Patients were divided into two groups based on gender： male and female groups, and matched them with age and AHI. The sleep structure, hvt）oxia and obiective and subjective sleepiness were compared between the two groups. Results A total of 258 patients was collected （ 129 female, 129 male） , The mean age and AHI were （49.38 ±11.34 ） years old and （ 35.29 ±26.67/h） in male patients, and （49.74 ±11.82 ） years old and （34.17 ±26.72/h） in female patients respectively. Comparing to male patients, female patients had a longer sleep latency[ （ 19.2± 28.1 ） vs （ 12.9 ±12.9） rain ], lower sleep efficiency [ （78.5 ±14.1 ） % vs （ 84.5± 9.7 ） % ], longer wake time after sleep onset [ （89.8 ±63.8） vs （66.1 ±48.4） mir, ], shorter total sleep time [ （396.9± 78.8） vs （427.6 ±56.1 ） min] and longer mean MSLT [ （9.9 ± 3.39） vs （9.3 ±3.7 ） min], （ All P 〈 0.05 ）. The percentage of hyperpnoea in male and female was [ （39.9 ±26.3 ） % vs （53.4 ±27.7） % ] , The percentage of apnea in male and female was [ （50.81 ±25.88） % vs. （41.03 ±26.72） % I, （ All P 〈 0.05 ）. Conclusion With a similar AHI, female perceived worse sleep quality than male pa- tients, but the MSLT was worse in male patients. Female patients, respiratory events give priority to hyperpnoea while male pa- tients,give priority to apnea.