阻塞性睡眠呼吸暂停低通气综合征患者快速眼动睡眠期呼吸紊乱的特点

目的 :研究阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)患者快速眼动睡眠期 (REM )呼吸暂停低通气的特点。方法 :复习 180例经多导睡眠仪确诊的OSAHS患者的睡眠监测结果 ,使用标准诊断指标睡眠呼吸暂停低通气指数 (AHI)以及睡眠呼吸紊乱时间 (RIT)指数 ,对患者REM期和非快速眼动睡眠期 (N REM)呼吸紊乱的特点进行分析。结果 :轻度患者REM期AHI明显高于N REM期 (P <0 .0 5 ) ,中、重度患者差异无统计学意义。重度患者REM期LSaO2 明显低于N REM期 (P <0 .0 5 )。结论 :①OSAHS患者常随病情加重 ,出现REM期睡眠时间减少甚至消失 ;②REM期呼吸暂停低通气较N REM期严重 ,主要表现在呼吸暂停低通气时间延长 ,而AHI变化不明显 ;③与AHI比较 ,RIT指数与患者呼吸暂停低通气的严重程度更具相关性。

Characteristics of respiratory disturbance during REM sleep in OSAHS

OBJECTIVE: To study the characteristics of respiratory disturbance during REM sleep in OSAHS through the signals surveyed by polysomnography (PSG). METHOD: The result of sleeping monitoring of 180 cases with OSAHS by PSG was reviewed, the AHI and the RIT index was used to evaluate the severity in different sleep stage as in REM and N-REM stage to find out the characteristics of the respiratory disturbance. RESULT: The study showed that AHI index in mild group increased greatly in REM period (P < 0.05), but no significant changes between the moderate and severe groups. And the lowest oxygen saturation (LSaO2) was lower during REM stage than that during N-REM stage (P < 0.05). CONCLUSION: (1) The time of REM in OSAHS patients often decreases according to their severity. (2) The respiratory disturbance during the stage REM is much severe than during the stage N-REM. The main manifestation is that the time of apnea-hypopnea is more longer and the AHI index does not significantly change. (3) The RIT index is more closely related to the severity of respiratory disturbance than AHI index.