经鼻持续气道正压通气对阻塞性睡眠呼吸暂停低通气综合征患者睡眠结构的影响

目的 评价经鼻持续气道正压通气(nCPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠结构的影响.方法 87例经多导睡眠图(PSG)诊断的OSAHS患者接受nCPAP和PSG监测,分析患者nCPAP治疗前、治疗中睡眠结构和病情严重度指标的改变.结果 患者在nCPAP治疗过程中睡眠结构和病情严重度指标发生明显改善,呼吸暂停低通气指数(AHI)由(54.45±28.85)次/h减至(8.11±13.41)次/h(F=184.528,P<0.001).最低血氧饱和度从(64.33±14.73)%升高至(75.08±15.52)%(F=21.948,P<0.001);平均血氧饱和度自(88.19±6.80)%升高为(91.99±3.87)%(F=20.469,P<0.001).I期睡眠占睡眠总时间的比率由(22.63土20.95)%减至(18.56±16.92)%,快动眼睡眠期比率自(13.28±10.25)%升高至(16.07±9.87)%,但均无统计学意义(F=1.984,P=0.161;F=3.347,P=0.069).Ⅱ期睡眠占睡眠总时间比率由(58.84±22.87)%减至(48.67±19.57)%(F=9.947,P=0.002).Ⅲ、Ⅳ期睡眠(慢波睡眠)从(6.29±7.16)%增至(17.01±9.84)%(F=67.511,P<0.001).结论 nCPAP改善OSAHS患者AHI、血氧饱和度的同时改善睡眠结构,主要增加患者的慢波睡眠,有明显即刻效应.

Influences of nasal continuous positive airway pressure on sleep architecture of obstructive sleep apnea-hypopnea syndrome patients

Objective To investigate the instant influences of nasal continuous positive airway pressure(nCPAP) on sleep architecture of obstructive sleep apnea-hypopnea syndrome(OSAHS) patients. Methods Eighty-seven OSAHS patients were diagnosed by polysomnography (PSG). The CPAP pressure was titrated during the first night. The patients accepted the whole night nCPAP treatment while PSG was monitored. The sleep architectures, apnea-hypopnea index(AHI) and arterial O2 saturation (SaO2) of OSAHS patients were analyzed before and during nCPAP therapy. Results Sleep architecture, AHI and SaO2 were significantly improved during therapy. AHI reduced from (54, 45±28. 85) times/h to (8.11± 13.41) times/h(F = 184. 528, P<0. 001). Minimum SaO2 increased from (64.33±14.73) % to (75.08 ± 15.52)% (F =21. 948, P <0. 001). Average SaO2 increased from (88.19±6.80)% to (91.99±3.87)% (F = 20. 469, P < 0.001). Stage I time vs total sleep time (TST) reduced from (22.63 ± 20.95) % to (18. 56±16.92) %,total REM sleep time vs TST increased from (13.28± 10.25)% to (16.07±9.87)%, but neither differences were significant (F = 1. 984, P = 0. 161 ; F = 3. 347, P = 0.069). Stage Ⅱ time vs TST reduced greatly from (58.84±22.87)% to (48.67±19.57)%(F =9. 947, P =0. 002). Total slow wave sleep times vs TST increased from (6.29±7.16) % to (17.01±9.84) %(F =67. 511, P <0. 001). Conclusions While AHI and SaO2 are significantly improved during therapy, nCPAP can improve the sleep architecture on OSAHS patients significantly.