Daytime sleepiness and its determining factors in Chinese obstructive sleep apnea patients
Daytime sleepiness and its determining factors in Chinese obstructive sleep apnea patients
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DOI：
10.1007/s11325-010-0337-4
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发表时间：
2011-01-01
影响因子：
2.5
通讯作者：
Liu, Chun-feng
中科院分区：
文献类型：
--
作者：
Chen, Rui;Xiong, Kang-ping;Liu, Chun-feng
本研究的目的是描述一个大型队列的中国阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的日间过度嗜睡（EDS）特征，并探讨其与临床/多导睡眠图变量的相关性。（平均年龄± SD 45 ± 15岁，体重指数26.6 ± 4.3 kg/m2）通过夜间多导睡眠图进行检查，并使用埃普沃思嗜睡量表（ESS）评估主观EDS。根据睡眠呼吸障碍的严重程度对1,035名患者进行比较：AHI < 5（原发性打鼾组或总体AHI正常）（24.1%），AHI 5-20（轻度OSAHS，21.7%），AHI > 20-40（中度OSAHS 16.5%），AHI > 40（重度OSAHS 37.7%）。ESS评分随着OSAHS严重程度的加重而逐渐增高。重度OSAHS患者以EDS、夜间低氧血症和睡眠结构紊乱为特征。轻度至重度OSAHS患者夜间低氧血症的进行性恶化与ESS评分密切相关。多元逐步回归分析显示，ESS评分与ODI、AHI、BMI显著相关，ODI是ESS评分的最强决定因素，EDS与OSAHS严重程度相关。更严重的患者的特征是较高的ESS评分、较高的BMI和夜间低氧血症的进行性恶化。夜间低氧血症是中国OSAHS患者EDS的主要决定因素。
The aim of this study was to characterize excessive daytime sleepiness (EDS) in a large cohort of Chinese patients with various severity of obstructive sleep apnea-hypopnea syndrome (OSAHS), and investigate its correlations with clinical/polysomnographic variables.A total of 1,035 consecutive Chinese patients with snoring (mean age +/- SD 45 +/- 15 years, BMI 26.6 +/- 4.3 kg/m(2)) were examined by overnight polysomnography, and subjective EDS was assessed using the Epworth Sleepiness Scale (ESS).The 1,035 patients were compared according to severity of sleep-disordered breathing: AHI < 5 (primary snoring group or normal overall AHI) (24.1%), AHI 5-20 (mild OSAHS, 21.7%), AHI > 20-40 (moderate OSAHS 16.5%), and AHI > 40 (severe OSAHS 37.7%). ESS score progressively increased as the severity of OSAHS aggravated among these patients. More severe OSAHS patients were characterized by EDS, nocturnal hypoxemia, and disruption of sleep structure. Progressive worsening of nocturnal hypoxemia was observed from mild to severe OSAHS patients with a strong correlation with ESS score. The stepwise multiple regression analysis performed to evaluate the correlations of individual clinical and polysomnographic variables with the ESS score revealed that the ESS score significantly correlated with the oxygen desaturation index (ODI), apnea-hypopnea index (AHI), and body mass index (BMI), and ODI was the strongest determinant of ESS score.EDS is correlated with the severity of OSAHS. More severe patients are characterized by higher ESS score, higher BMI, and progressive worsening of nocturnal hypoxemia. Nocturnal hypoxemia is a major determinant of EDS in Chinese OSAHS patients.