Prevalence, characteristics, and respiratory arousal threshold of positional obstructive sleep apnea in China: a large scale study from Shanghai Sleep Health Study cohort.
Prevalence, characteristics, and respiratory arousal threshold of positional obstructive sleep apnea in China: a large scale study from Shanghai Sleep Health Study cohort.
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DOI：
10.1186/s12931-022-02141-3
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发表时间：
2022-09-12
影响因子：
5.8
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中科院分区：
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--
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根据Cartwright分类（CC）和阿姆斯特丹体位性阻塞性睡眠呼吸暂停分类（APOC）评估中国体位性阻塞性睡眠呼吸暂停（POSA）患者的患病率、特征和呼吸唤醒阈值（ArTH）。本研究于2007 - 2018年在睡眠中心开展大规模横断面研究，分析中国POSA患者的临床和多导睡眠图（PSG）数据。根据PSG指标定义低ArTH。在5748例OSA患者中，36.80%符合POSA的CC标准，42.88%符合APOC标准。POSA的女性患病率明显高于男性（40.21%和46.52%，而CC和APOC的患病率分别为36.13%和42.18%）。与非体位性OSA （NPOSA）患者相比，中国POSA患者呼吸暂停低通气指数（AHI）和氧去饱和指数较低，血氧饱和度(SaO2) < 90%持续时间较短，平均SaO2和最低SaO2值较高。超过40%的POSA患者存在低ArTH；在仰卧分离posa （si-POSA）组和APOC I组中比例极高。在多变量logistic回归分析中，睡眠期间较高的平均SaO2和较低的AHI是POSA的积极预测因子。根据CC和APOC标准，超过1/3的中国OSA患者有POSA。中国POSA患者的严重OSA和夜间缺氧较轻。与NPOSA患者相比，POSA患者的低ArTH明显更多。低ArTH可能是POSA发病机制的重要内型，特别是在si-POSA和APOC患者中。需要进一步的研究来制定POSA患者的个性化管理策略。试验注册：Chinese Clinical Trial Registry；URL: http://www.chictr.org.cn;否。ChiCTR1900025714（回顾性注册）。在线版本包含补充材料，可在10.1186/s12931-022-02141-3获得。
To evaluate the prevalence, characteristics, and respiratory arousal threshold (ArTH) of Chinese patients with positional obstructive sleep apnea (POSA) according to the Cartwright Classification (CC) and Amsterdam Positional Obstructive Sleep Apnea Classification (APOC). A large-scale cross-sectional study was conducted in our sleep center from 2007 to 2018 to analyze the clinical and polysomnography (PSG) data of Chinese POSA patients. Low ArTH was defined based on PSG indices. Of 5,748 OSA patients, 36.80% met the CC criteria, and 42.88% the APOC criteria, for POSA. The prevalence of POSA was significantly higher in women than men (40.21% and 46.52% vs. 36.13% and 42.18% for CC and APOC, respectively). Chinese POSA patients had a lower apnea hypopnea index (AHI) and lower oxygen desaturation index, shorter duration of oxygen saturation (SaO2) < 90%, and a higher mean SaO2 and higher lowest SaO2 value compared to subjects with non-positional OSA (NPOSA). More than 40% of the POSA patients had a low ArTH; the proportion was extremely high in the supine-isolated-POSA (si-POSA) group and APOC I group. In multivariate logistic regression analyses, higher mean SaO2 and lower AHI during sleep were positive predictors of POSA. According to the CC and APOC criteria, more than 1/3 of our Chinese subjects with OSA had POSA. Chinese POSA patients had less severe OSA and nocturnal hypoxia. Compared to NPOSA patients, significantly more patients with POSA had a low ArTH. A low ArTH may be an important endotype in the pathogenesis of POSA, especially in patients with si-POSA and APOC I. Further studies are necessary to develop personalized management strategies for POSA patients. Trial registration: Chinese Clinical Trial Registry; URL: http://www.chictr.org.cn; No. ChiCTR1900025714 (retrospectively registered). The online version contains supplementary material available at 10.1186/s12931-022-02141-3.
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