Sleep-Disordered Breathing and Excessive Daytime Sleepiness in Patients With Atrial Fibrillation
Sleep-Disordered Breathing and Excessive Daytime Sleepiness in Patients With Atrial Fibrillation
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DOI：
10.1378/chest.11-0975
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发表时间：
2012-04-01
期刊：
影响因子：
9.6
通讯作者：
Caples, Sean M.
中科院分区：
文献类型：
--
作者：
Albuquerque, Felipe N.;Calvin, Andrew D.;Caples, Sean M.
背景：睡眠呼吸障碍（SDB）的一个重要后果是白天过度嗜睡（EDS）。 EDS 通常预测对 SDB 治疗的良好反应，尽管在心血管疾病，特别是心力衰竭的情况下，SDB 和 EDS 并不可靠相关。心房颤动（AF）。是另一种与 SDB 密切相关的高度流行的疾病。我们试图评估 AF 患者中 EDS 和 SDB 之间的关系。方法：我们对 151 名因 AF 转诊接受直流电复律的患者进行了一项前瞻性研究，这些患者还接受了睡眠评估和夜间多导睡眠图。在多导睡眠图之前进行 Epworth 嗜睡量表 (ESS)，如果分数 >= 11，则视为阳性。测试呼吸暂停低通气指数 (AHI) 与 ESS 的相关性，诊断 SDB 的截止值为 >= 5 次事件/小时。结果：在研究参与者中，平均年龄为 69.1 +/- 11.7 岁，平均 BMI 为 34.1 +/- 8.4 kg/m(2)，76%为男性。该人群中 SDB 的患病率为 81.4%，其中 35% 患有 EDS。 ESS 评分与 AHI 之间的相关性较低（R-2 = 0.014，P = .64）。 ESS 检测 AF 患者 SDB 的敏感性和特异性分别为 32.2% 和 54.5%。结论：尽管 AF 人群中 SDB 患病率较高，但大多数患者并未报告 EDS。此外，EDS 似乎与 SDB 的严重程度无关，也无法准确预测 SDB 的存在。需要进一步的研究来确定 EDS 是否影响 AF 的自然史或改变对 SDB 治疗的反应。胸部 2012； 141(4):967-973
Background: An important consequence of sleep-disordered breathing (SDB) is excessive daytime sleepiness (EDS). EDS often predicts a favorable response to treatment of SDB, although in the setting of cardiovascular disease, particularly heart failure, SDB and EDS do not reliably correlate. Atrial fibrillation (AF). is another highly prevalent condition strongly associated with SDB. We sought to assess the relationship between EDS and SDB in patients with AF.Methods: We conducted a prospective study of 151 patients referred for direct current cardioversion for AF who also underwent sleep evaluation and nocturnal polysomnography. The Epworth Sleepiness Scale (ESS) was administered prior to polysomnography and considered positive if the score was >= 11. The apnea-hypopnea index (AHI) was tested for correlation with the ESS, with a cutoff of >= 5 events/h for the diagnosis of SDB.Results: Among the study participants, mean age was 69.1 +/- 11.7 years, mean BMI was 34.1 +/- 8.4 kg/m(2), and 76% were men. The prevalence of SDB in this population was 81.4%, and 35% had EDS. The association between ESS score and AHI was low (R-2 = 0.014, P = .64). The sensitivity and specificity of the ESS for the detection of SDB in patients with AF were 32.2% and 54.5%, respectively.Conclusions: Despite a high prevalence of SDB in this population with AF, most patients do not report EDS. Furthermore, EDS does not appear to correlate with severity of SDB or to accurately predict the presence of SDB. Further research is needed to determine whether EDS affects the natural history of AF or modifies the response to SDB treatment. CHEST 2012; 141(4):967-973