上海市30岁以上人群阻塞性睡眠呼吸暂停低通气综合征流行病学调查

Prevalence of obstructive sleep apnea-hypopnea syndrome in Chinese adults aged over 30 yr in Shanghai

目的 调查阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)的人群患病率 ,为制定该病的防治策略提供依据。方法 采用整群抽样的方法对上海市卢湾区、徐汇区、杨浦区、浦东新区 4区 6个街道常住 30岁以上居民 96 0 0人 ,进行问卷调查 ;根据打鼾程度 ,从中、重度组随机抽样 15 0例 ,行整夜便携式多导睡眠检测仪监测 ,保守估计人群OSAHS的患病率。结果 实际调查人数 80 81人 (应答率为 84 18% ) ,其中有效问卷 6 82 6份 (有效率为 84 4 7% )。其中打鼾者占 5 7 11% ,中、重度打鼾者占 2 3 73%。且随着年龄的增加 ,打鼾者比例逐渐增加 ,70岁后呈下降趋势。男性高于女性 ,尤见于中、重度者。吸烟和饮酒与打鼾程度相关。绝经者和月经不规律者打鼾的发生率及程度均较规律者为高。不同程度打鼾患者 ,日间的嗜睡评分有明显差异。按睡眠呼吸暂停低通气指数 (AHI)≥ 5次 /h为标准 ,人群OSAHS的发生率为 2 0 39%。结合日间Epworth嗜睡量表 (ESS)评分≥ 9分为标准 ,保守估计人群OSAHS的患病率为 3 6 2 %。结论 我国大陆 30岁以上人群OSAHS患病率保守估计为3 6 2 % ,是影响公众健康的重要问题之一 ,应当引起足够的重视。

Objective To investigate the prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) in adults aged over 30 yr in Shanghai, to provide data for estimating the burden of this disease and making strategies for treatment and prevention of this disorder. Methods 9 600 subjects (aged ≥30 yr) were derived from a random sample of the population living in six streets, four districts in Shanghai. They were asked to answer the questions from a questionnaire concerning snoring, daytime sleepiness, and habits such as smoking and drinking, etc. According to the degree of snoring, 150 moderate and severe snorers were selected to be tested by portable PSG for whole night data. The prevalence of OSAHS was conservatively estimated from the result. Results 8 081 subjects (84.18%) had answered the questions, among them 6 826(84.47%) were available for evaluation. The prevalence of ever snoring was 57.11%, moderate and severe ones 23.73%. Before the age of 70,the prevalence of snoring increased with age, and higher in males than females, particularly for moderate and severe snoring. Smoking and drinking were associated with the severity of snoring. The prevalence was higher in women post-menopause and with irregular menstruation. ESS was significantly different among snorers with various severities. When AHI≥5 was taken as the cut-point,the prevalence of OSAHS was 20.39%. After excessive daytime sleepiness(EDS) definited as ESS≥9 was added as a criterian, the conservatively estimated prevalence of OSAHS was 3.62%. Conclusions The estimated prevalence of OSAHS in adults over 30 yr old was 3.62%. This can be a great burden to public health and implies that the disease needs better understanding and study.