阻塞性睡眠呼吸暂停低通气综合征患者睡眠结构的研究

目的：研究阻塞性睡眠呼吸暂停低通气综合征(OSAHs)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：对46例OSAHs患者(OSAHs组)、16例单纯鼾症(鼾症组)及20例正常人(对照组)进行睡眠监测，对非快速眼动(NREM)、快速眼动(REM)睡眠各期所占比例计算其百分比，并统计呼吸紊乱指数(RDI)、呼吸暂停指数(AI)、低通气指数(HD．观察OSAHS患者和单纯鼾症患者在睡眠时总的微觉醒指数(MI，次／h)、伴呼吸紊乱的MI、伴腿动的MI、伴鼾声的MI、自发性MI的差别。结果：OSAHS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．OSAHS患者在其仅有的浅睡眠中伴有明显多的微觉醒，并且这种微觉醒伴有明显多的腿动和(或)呼吸紊乱，OSAHS患者的自发性微觉醒也明显增多。结论：OSAHS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而导致的脑代谢紊乱，是其白天嗜睡、乏力、记忆力减退的直接原因。

Research about sleep struction of OSAHS

OBJECTIVE: Research the sleep structure of the OSAHS and snores, explore the reason that patients feel drowsy in daytime. METHOD: Monitor the sleep of 46 OSAHS, 16 snores and 20 normal control, calculate the percent of stages of NREM and REM, count the RDI, AI, HI, total MI, MI associated with leg movement, MI associated with RDI, MI associated with snore, spontaneous MI. RESULT: OSAHS has sleep structure disturbance obviously. The light sleep (stage I) increase obviously, but deep one decrease (stage II + V) obviously. The sleep structure is insufficient. The patients are deprived of a number of the REM sleep. The waking time is longer than normal control group. During the light sleep, the microarousal that is associated with both apnea and leg movement increase obviously. CONCLUSION: During the sleep, OSAHS has obvious sleep deprivation, frequent arousal, disturbance sleep structure and blood desaturation, etc. These resulted in disturbances of brain metabolize. This is the reason that patients feel drowsy, feeble decline, etc.