右佐匹克隆在慢性失眠症伴轻中度阻塞性睡眠呼吸暂停低通气综合征患者睡眠监测中的应用

Application of Eszopiclone in sleep monitoring of chronic insomnia patients with mild to moderate obstructive sleep apnea hypopnea syndrome

目的研究右佐匹克隆在慢性失眠症伴轻中度阻塞性睡眠呼吸暂停低通气综合症(OSAHS)患者睡眠监测中的作用。方法 选取2018年6月~2019年6月四川大学华西第四医院睡眠呼吸疾病诊治中心诊断为慢性失眠症的患者,对其进行连续7 h以上的多道睡眠监测(polysomnography,PSG),筛选出伴有轻中度OSAHS且自愿参与研究的患者41例,在第2天晚上睡前30 min口服右佐匹克隆3 mg后再次行整夜PSG监测,收集服药前后两夜PSG监测相关指标:呼吸暂停低通气指数(apnea hypopnea index,AHI)、最低血氧饱和度、总睡眠时长、睡眠潜伏期、觉醒次数、睡眠分期等。比较服药前后多导睡眠监测指标的变化情况。结果 口服右佐匹克隆后患者的AHI、最低血氧饱和度与服药前[(13.27±6.04)vs(15.00±6.33)、(83.24±4.81)vs(83.05±5.08)]相比差异无统计学意义(P>0.05);总睡眠时长较服药前明显延长[(416.15±26.06)vs(314.22±17.11)](P<0.05),睡眠潜伏期较服药前缩短[(20.83±9.15)vs(49.56±13.67)](P<0.05),觉醒次数较服药前减少[(2.98±1.15)vs(7.56±2.79)](P<0.05);睡眠N1、N2期占比均较服药前减少,N3期、R期占比均较服药前增加。结论 对慢性失眠症伴轻中度OSAHS的患者,在PSG监测前30 min口服3 mg右佐匹克隆不但能缩短睡眠潜伏期,改善患者的睡眠质量,还能减少重复监测的可能。

OBJECTIVE To investigate the effect of eszopiclone on sleep monitoring in patients with chronic insomnia with mild to moderate obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS Patients with chronic insomnia diagnosed by the Diagnosis and Treatment Center of Sleep Apnea Disease,West China Fourth Hospital,Sichuan University,from June 2018 to June 2019 were monitored for polysomnography(PSG) for more than 7 hours.Forty-one patients with mild to moderate OSAHS were selected and voluntarily participated in the study.PSG monitoring was performed again after taking 3 mg eszopiclone orally 30 min on the second night.The related indexes of PSG monitoring of the two nights were recorded:apnea hypopnea index(AHI),lowest oxygen saturation,total sleep duration,sleep latency,awakening times,sleep stages and so on.The related indexesof the two nights were compared.RESULTS There were no statistically significant differences in the AHI and lowest blood oxygen saturation in patients with chronic insomnia and mild to moderate OSAHS monitored after taking of eszopiclone[(13.27±6.04) vs (15.00±6.33),(83.24±4.81) vs (83.05±5.08)].The total sleep duration was significantly longer than that before taking theeszopiclone[(416.15±26.06) vs (314.22±17.11)](P<0.05),the sleep latency was shorter than that before taking theeszopiclone[(20.83±9.15) vs (49.56±13.67)](P<0.05),and the number of awakenings was lower than that before taking the eszopiclone[(2.98±1.15) vs (7.56±2.79)](P<0.05).The proportion of patients in stage N1and N2 was lower than that before taking the eszopiclone(P<0.05),while the proportion in stage N3 and Stage R were higher than that before taking the eszopiclone(P<0.05).CONCLUSIONFor patients with chronic insomnia and mild to moderate OSAHS,oral administration of 3 mg eszopiclone 30 minutes before PSG monitoring can not only shorten the sleep latency period and improve the sleep quality of the patients,but also reduce the possibility of repeated monitoring.