Morbidity cut-offs for sleep apnea and periodic leg movements in predicting subjective complaints in seniors.
Morbidity cut-offs for sleep apnea and periodic leg movements in predicting subjective complaints in seniors.
复制标题
睡眠呼吸暂停和周期性腿部运动的发病率临界值可预测老年人的主观主诉。
作者：
Dickel,MJ;Mosko,SS
尽管广泛使用，但尚未确定任何老年人群中呼吸紊乱指数（RDI）或运动指数（MI）的5/h发病率截止值在确定是否存在睡眠呼吸暂停（SA）或睡眠相关周期性腿部运动（PLM）方面的有效性。100名60岁或以上的社区居民老年人接受了连续三个晚上的多导睡眠描记术，并完成了主观睡眠-觉醒投诉（书面睡眠问卷，睡眠日志，睡眠访谈）和情绪障碍（Zung抑郁和焦虑自评量表，情绪状态简介，Beck抑郁量表）的常规测量。根据第5个临界值，34%的人有SA，58%的人有PLM。尽管如此，在各种评估方法中，主观睡眠-觉醒和情绪障碍的频率较低。由RDI或MI的5/h截止值形成的组在所有主观睡眠-觉醒和情绪测量的反应上没有显著差异。更高的截止值也被检查，并证明在预测主观睡眠-觉醒和情绪障碍方面是弱或无效的。初步研究表明，在该人群中，SA严重程度的替代指标（x氧饱和度下降和x呼吸暂停或呼吸不足持续时间）可能比RDI更能预测主观障碍。这些发现（a）证明了在老年人中广泛存在的多导生理学识别的SA和PLM往往不会表现为自我报告的睡眠-觉醒或情绪障碍，（B）说明了需要验证SA和PLM的发病率截止值。
Despite its widespread use, the validity of the 5/h morbidity cut-off for the Respiratory Disturbance Index (RDI) or the Movement Index (MI) in determining presence of sleep apnea (SA) or sleep-related periodic leg movements (PLMs), respectively, has not been determined for any aged population. One hundred community resident seniors 60 years of age or older underwent three consecutive nights of polysomnography and also completed conventional measures of subjective sleep-wake complaints (written sleep questionnaire, sleep log, sleep interview) and mood disturbances (Zung Self-Rating Depression and Anxiety Scales, Profile of Mood States, Beck Depression Inventory). Based on the 5th cut-off, 34% had SA and 58% had PLMs. Despite this, the frequency of subjective sleep-wake and mood disturbance was low across methods of assessment. Groups formed by the 5/h cut-off for RDI or MI failed to differ significantly in responses on all subjective sleep-wake and mood measures. Higher cut-offs also were examined and proved weak or ineffective in predicting subjective sleep-wake and mood disturbance. Preliminary investigations suggested that alternative measures of severity of SA (x oxygen desaturation and x duration of apneas or hypopneas) may be better predictors of subjective disturbance than RDI in this population. These findings both (a) demonstrate that the polygraphically identified SA and PLMs which are widespread in seniors tend not to be manifested in self-reported sleep-wake or mood disturbance, and (b) illustrate the need for validated morbidity cut-offs for SA and PLMs.