Rapid eye movement-related disordered breathing - Clinical and polysomnographic features
Rapid eye movement-related disordered breathing - Clinical and polysomnographic features
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DOI：
10.1378/chest.128.5.3350
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发表时间：
2005-11-01
期刊：
影响因子：
9.6
通讯作者：
Sforza, E
中科院分区：
文献类型：
--
作者：
Haba-Rubio, J;Janssens, JP;Sforza, E
目的：根据发现困倦与主要限于快速眼动睡眠的呼吸障碍之间的关联，提出存在快速眼动（REM）特异性睡眠呼吸障碍（SDB）。本研究的目的是确定大量临床人群中 REM SDB 的频率以及临床和多导睡眠图特征。方法：对 415 名因 SDB 接受多导睡眠监测的患者进行人体测量、临床和多导睡眠图特征检查。对于所有患者，计算总睡眠时间期间的呼吸暂停低通气指数 (AHI)、快速眼动睡眠期间的 AHI (AHI-REM) 和非快速眼动睡眠期间的 AHI (AHI-NREM)。 REM SDB 定义为 AHI-REM/AHI-NREM 比率 > 2。根据疾病严重程度对患者进行分层，分为轻度、中度和重度病例。白天嗜睡情况通过 Epworth 嗜睡量表 (ESS) 进行主观评估，并在 228 名患者的亚组中通过维持清醒测试 (MWT) 进行客观评估。 结果：在初始样本中，36.4% 的病例 (n = 151) 符合 REM SDB 标准。 REM 和非 REM SDB 患者的主观主诉、病史和药物摄入量没有显着差异，组间 ESS 评分和 MWT 平均睡眠潜伏期也没有显着差异。轻度（73.1%）和中度（47.2%）病例中 REM SDB 发生率较高。虽然在整个组和非 REM SDB 患者中，男性患病率很高，但 REM SDB 的发病率在男性和女性中相似。结论：我们的结果表明，临床病史和白天嗜睡都无法区分 REM SDB 患者和非 REM SDB 患者。这种疾病在轻度和中度病例中更为常见；女性和男性的发病率相同。这些发现可能表明与 REM 相关的 SDB 是 SDB 谱系的一部分。
Objective: The existence of a rapid eye movement (REM)-specific sleep-disordered breathing (SDB) has been suggested based on the finding of an association between sleepiness and respiratory disturbances confined primarily to REM sleep. The aim of the study was to define the frequency and the clinical and polysomnographic features of REM SDB in a large clinical population.Methods: Anthropometric, clinical, and polysomnographic characteristics of 415 patients undergoing polysomnography for SDB were examined. For all patients the apnea-hypopnea index (AHI) during total sleep time, the AHI during REM (AHI-REM), and the AHI during non-REM sleep (AHI-NREM) were calculated. REM SDB was defined as an AHI-REM/AHI-NREM ratio > 2. Patients were stratified according to the severity of disease in mild, moderate, and severe cases. Daytime sleepiness was assessed subjectively by the Epworth sleepiness scale (ESS), and objectively, in a subgroup of 228 patients, by the maintenance wakefulness test (MWT).Results: Of the initial sample, 36.4% of cases (n = 151) fulfilled the REM SDB criteria. No significant differences in subjective complaints, medical history, and drug intake were present between REM and non-REM SDB patients, and no significant differences were found in ESS scores and mean sleep latency of the MWT between groups. A high occurrence of REM SDB was found in mild (73.1%) and moderate cases (47.2%). While in the entire group and in non-REM SDB patients a strong male prevalence was found, the incidence of REM SDB was similar in men and women.Conclusion: Our results show that neither clinical history nor daytime sleepiness differentiate patients with REM SDB from non-REM SDB patients. The disorder is more common in mild and moderate cases; there is an equal incidence in women and men. These findings may suggest that REM-related SDB is a part of the spectrum of SDB.