Prevalence of Rapid Eye Movement-related Obstructive Sleep Apnea in Adult Narcolepsy
Prevalence of Rapid Eye Movement-related Obstructive Sleep Apnea in Adult Narcolepsy
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DOI：
10.2169/internalmedicine.2601-18
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发表时间：
2019-01-01
影响因子：
1.2
通讯作者：
Shiomi, Toshiaki
中科院分区：
文献类型：
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作者：
Hoshino, Tetsuro;Sasanabe, Ryujiro;Shiomi, Toshiaki
目的发作性睡病与快速眼动(REM)相关性阻塞性睡眠呼吸暂停(OSA)的关系尚未见报道。本研究旨在调查发作性睡病患者中REM相关阻塞性睡眠呼吸暂停的患病率。采用夜间多导睡眠图和多重睡眠潜伏期试验对141例成人发作性睡病患者进行诊断。本文回顾了发作性睡病患者中REM相关性阻塞性睡眠呼吸暂停的发生率。使用三个标准来确定与REM相关的OSA：定义#1，总体呼吸暂停低通气指数(AHI)=5和REM期间AHI(AHIREM)/非快速眼动(NREM)AHI(AHINREM)>；=2；定义#2，总体AHI和AHI(REM)/AHI(NREM)>；=2和AHI(NREM)=5和AHI(REM)/AHI(NREM)>；结果141例发作性睡病患者中，26例为发作性睡病(NA-CA)，115例为发作性睡病(NA w/o CA)。17例NA-CA和39例NA w/o CA患者有OSA。根据定义1，REM相关OSA的患病率分别为47.1%和41.0%。在合并NA-CA和NA w/o CA的OSA患者中，按定义2的患病率分别为47.1%和38.5%，而按定义3的患病率分别为41.2%和25.6%。结论REM相关OSA在成人发作性睡病合并OSA患者中的患病率较高。与以前的报道相比，我们注意到与REM相关的OSA出现的频率很高，符合相对严格的定义#3。这些结果可能反映了发作性睡病的病理生理学特征。
Objective The association between narcolepsy and rapid eye movement (REM)-related obstructive sleep apnea (OSA) has not been reported. This study aimed to examine the prevalence of REM-related OSA in narcolepsy patients.Methods From January 2013 to April 2018. 141 adult patients were diagnosed with narcolepsy using nocturnal polysomnography and the multiple sleep latency test. The prevalence of REM-related OSA in narcolepsy patients was retrospectively reviewed. Three criteria were used to determine REM-related OSA: Definition #1, an overall apnea-hypopnea index (AHI) >= 5 and AHI during REM (AHIREM)/AHI during non-rapid eye movement (NREM) (AHINREM) >= 2; Definition #2, an overall AHI >= 5 and AHI(REM))/AHI(NREM) >= 2 and AHI(NREM) = 5 and AHI(REM))/AHI(NREM) >= 2 and AHI(NREM) 10.5 minutes.Results Of the 141 narcolcpsy patients, 26 were diagnosed with narcolepsy with cataplexy (NA-CA) and 115 with narcolepsy without cataplexy (NA w/o CA). Seventeen patients with NA-CA and 39 with NA w/o CA had OSA. According to Definition #1, the prevalence of REM-related OSA was 47.1% and 41.0%, respectively. in OSA patients with NA-CA and NA w/o CA; according to Definition #2, the respective prevalence was 47.1% and 38.5%, while that according to Definition #3 was 41.2% and 25.6%. No significant differences were found in the prevalence of REM-related OSA for each definition.Conclusion A high prevalence of REM-related OSA was confirmed in adult narcolepsy patients with OSA. Compared to previous reports, we noted a high frequency of REM-related OSA satisfying the relatively strict Definition #3. These results might reflect the pathophysiological characteristics of narcolepsy.