快速动眼睡眠型和非快速动眼睡眠型阻塞性睡眠呼吸暂停综合征患者的临床特征分析

目的 比较快速动眼睡眠(REM)型和非REM(NREM)型阻塞性睡眠呼吸暂停综合征(OSA)患者的临床特征、多导睡眠监测(PSG)参数和血清学指标间的差异.方法 收集2018年1月至2019年6月住院且PSG提示总呼吸暂停低通气指数(AHI)≥5的OSA患者129例.统计REM期AHI值(AHIREM)和NREM期AH...

Analysis of clinical features between rapid eye movement and non-rapid eye movement related obstructive sleep apnea

Objective To compare differences in clinical features,polysomnographic(PSG)features and serum marker between rapid eye movement(REM)related obstructive sleep apnoea(OSA)and non-REM(NREM)related OSA patients.Methods Total 129 patients with a diagnosis of OSA who had apnea hypopnea index(AHI)≥5 during January 2018 to June 2019 were involved.The AHI of REM(AHI_REM)and the AHI of NREM(AHI_NREM)were calculated.According to Oksenberg classification,patients with AHI_REM/AHI_NREM≥2 were classified as REM-OSA group,and patients with AHI_REM/AHI_NREM<2 were classified as NREM-OSA group.The parameters including sex,age,body mass index(BMI),first visit compliance rate,Epworth sleepiness scale(ESS),Pittsburgh sleep quality index(PSQI),self-rating depression scale(SDS),self-rating anxiety scale(SAS),PSG,hypersensitive C-reactive protein,IL-6 and carbon dioxide binding rate,et al.Results There were significant differences in sex,age,BMI,first visit compliance rate,SAS scores,AHI_NREM,total AHI,lowest blood oxygen saturation(L-SaO₂),cumulative percentage of time spent at saturation below 90%(CT90),serum high sensitivity C-reactive protein and carbon dioxide binding rate between the two groups(all P<0.05).The correlation analysis shows that,there were negative correlations between L-SaO₂and BMI,PSQI score,total sleep time,sleep efficiency,percentage of total sleep time in NREM 2,total AHI,AHI_NREM,AHI_REM,AHI_REM/AHI_NREMratio,serum high sensitivity C-reactive protein in OSA patients(all P<0.05).There were positive correlations between total AHI and BMI,sleep efficiency,AHI_NREM,AHI_REMand serum high sensitivity C-reactive protein in OSA patients(all P<0.05).There were negative correlations between total AHI and sex,AHI_REM/AHI_NREMratio in OSA patients(all P<0.05).Conclusions This study demonstrates that in comparison with NREM-OSA,REM-OSA occurs more commonly in women and younger individuals who even not fat.REM-OSA is more serious than NREM-OSA,which the L-SaO₂is lower,CT90 is higher and the serum carbon dioxide binding rate and the level of hypersensitive C-reactive protein are increased.The lowest oxygen reduction occurres in REM sleep stage and correlated with sleep quality in both groups.So REM-OSA is not only a simple classifications in the sense of numbers,but more likely to be a neglected diagnosis.Active early recognition and treatment may bring benefits to patients.