失眠合并阻塞性睡眠呼吸暂停低通气综合征患者的夜间睡眠图结构特征

Polysomnographic Characteristics of Insomnia Patients with Comorbid Obstructive Sleep Apnea-hypopnea Syndrome

目的探讨失眠合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的夜间睡眠图结构特征。方法对于2013年8月-12月就诊的单纯失眠患者(n=80)、单纯OSAHS患者(n=80)及失眠合并OSAHS患者(n=50)的多导睡眠图资料进行对比分析。结果与单纯OSAHS患者相比,失眠合并OSAHS患者中女性较多,年龄更大,体质量指数较低,夜间总睡眠时间较短,入睡潜伏期及睡后觉醒时间更长,睡眠效率更低,微觉醒指数及呼吸暂停低通气指数(AHI)更低,平均血氧饱和度和最低血氧饱和度更高,Epworth嗜睡量表评分更低,睡眠知觉下降,差异均有统计学意义(P<0.05);与单纯失眠患者相比,失眠合并OSAHS患者女性所占比例更低,总睡眠时间更短,睡眠效率更低,睡后觉醒时间更长,AHI明显升高,最低血氧饱和度明显下降,差异均有统计学意义(P<0.05)。结论失眠合并OSAHS患者的睡眠既有失眠患者的睡眠特点亦有OSAHS患者的睡眠特点,患者存在夜间缺氧,睡眠片段化,睡眠效率、总睡眠时间及睡眠知觉受损。

Objective To assess the polysomnographic characteristics of insomnia patients with comorbid obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods We performed a comparative analysis on the polysomnographic features among patients with pure insomnia （n=80）, patients with pure OSAHS （n=80）, and patients with insomnia and OSAHS （n=50） between August and December 2013. Results Compared with OSAHS group, patients with insomnia and comorbid OSAHS had a higher percentage of female, older age, lower body mass index, shorter total sleep time during the night, longer sleep latent period and wake after sleep onset （WASO）, lower sleep efficacy, lower arousal index and apnea hypoventilation index （AHI）, higher average and the lowest oxygen saturation of blood, lower Epworth Sleepiness Scale scores and sleep perception （P 〈 0.05）. Compared with the insomnia group, patients with insomnia and comorbid OSAHS had a lower percentage of female, shorter total sleep time, lower sleep efficacy, longer WASO and higher AHI （P 〈 0.05）. Conclusion Patients with insomnia and comorbid OSAHS have all the characteristics of insomnia and OSAHS patients： nocturnal hypoxia, sleep fragmentation, broken sleep continuity, decreased sleep efficiency, damaged perception of sleep time and sleep perception.