摘要
目的 :研究阻塞性睡眠呼吸暂停综合征 (OSAS)及单纯鼾症的睡眠结构 ,探讨患者白天嗜睡等症状的原因。方法 :监测OSAS 32例、单纯鼾症 8例及正常对照 18例的睡眠 ,计算NREM、REM睡眠各期所占比例 ,统计呼吸紊乱指数 (RDI)、呼吸暂停指数 (AI)、低通气指数 (HI) ,观察OSAS患者和单纯鼾症在睡眠时总的微觉醒指数 (次 h) (MI)、伴呼吸紊乱的MI、伴腿动的MI、伴鼾声的MI、自发性MI上的差别。结果 :OSAS患者有明显的睡眠结构紊乱 ,其浅睡眠明显增多 ,深睡眠明显减少 ,睡眠结构不全 ,有明显的REM睡眠剥夺现象 ,醒觉时间明显延长 ,OSAS患者在其仅有的浅睡眠中伴有较多的微觉醒 ,并且这种微觉醒伴有较多的腿动和 (或 )呼吸紊乱 ,OSAS患者的自发性微觉醒也明显增多。结论 :OSAS患者睡眠时的睡眠剥夺 ,特别是REM期睡眠剥夺、频繁唤醒、睡眠结构紊乱及呼吸紊乱引起的减血氧引起了脑代谢紊乱 ,是患者白天嗜睡、乏力。
Objective:To research the sleep structure of the OSAS and snores,and explore the reasons that patients feel drowsy in daytime.Methods:32 patients with OSAS,8 patients with snores and 18 normal control men were monitored the sleep course and calculated the percent of stages of NREM and REM,counted the RDI,AI,HI,total MI,MI associated with leg movement,MI associated with RDI,MI associated with snore,spontaneous MI.Results:OSAS had sleep structure disturbance obviously.The light sleep (stage I) increased obviously,but deep one decreased (stage Ⅲ+Ⅴ) obviously.The sleep structure was insufficient.The patients were deprived of a number of the REM sleep.The waking time was longer than that of normal control group.During the light sleep,the microarousal that was associated with both apnea and leg movement increases obviously.Conclusion:During the sleep,OSAS has obvious sleep deprivation,frequent arousal,disturbance sleep structure,blood desaturation,etc,which result in disturbances of brain metabolize.This is the reason that patients feel drowsy,feeble and memory decline.
