青年与中老年OSA患者睡眠监测结果的对比分析
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摘要
目的:比较青年与中老年OSA患者的夜间睡眠缺氧程度及睡眠结构,为缓解OSA患者的睡眠问题提供一个新的研究方向。方法:选择2017-02-2019-01期间确诊为OSA的438例患者,其中青年组119例,年龄(28.5±5.1)岁;中老年组319例,年龄(45.8±2.7)岁,回顾性分析2组患者PSG记录的结果。结果:①青年组的AHI、氧减指数、阻塞性呼吸暂停指数、混合性呼吸暂停指数、平均血氧饱和度均明显高于中老年组,而中枢性呼吸暂停指数组间差异无统计学意义(P=0.419)。②中老年组非快速动眼睡眠期(NREM)的Ⅰ期(61.1±4.3)%明显高于青年组(53.3±3.4)%,而青年组的NREM的Ⅱ期(33.2±2.3)%、Ⅲ+Ⅳ期(4.3±1.3)%均高于中老年组Ⅱ期(29.2±3.9)%、Ⅲ+Ⅳ期(2.6±0.9)%。NREM各分期睡眠所占的百分率在2组间差异有统计学意义(P <0.05),而快速动眼睡眠期(REM期)所占的百分率及微觉醒指数在2组间差异无统计学意义(P>0.05)。③青年组46.2%伴有高血压,中老年组47.0%伴有高血压,2组间差异无统计学意义。结论:NREM期特别容易受到年龄的影响,年龄影响慢波睡眠。中老年人的睡眠结构展示了其睡眠特征:总睡眠时间减少、慢波睡眠、睡眠效率低、睡眠延迟。青年人的夜间缺氧程度更为严重,AHI、氧减指数、阻塞性呼吸暂停指数、混合性呼吸暂停指数、平均血氧饱和度等指标均明显高于中老年人,但睡眠结构2组相近,显示青年人有很强的睡眠生理代偿和调节能力。
Objective:The aim of this study is to compare the night sleep hypoxia degree and sleep structure of young and middle-aged and elderly patients with OSA,so that PSG has more important application value.Method:A total of 438 patients diagnosed with OSA from February 2017 to January 2019 were selected,including 119 patients in the youth group with an average age of(28.5±5.1)years,and 319 patients in the middle and elderly group with an average age of(45.8±2.7)years.The results recorded by PSG in the two groups were retrospectively analyzed.Result:①The AHI,ODI,OAI,MAI and ASaO_2 of OSA patients in the junior group were significantly higher than those in the middle-aged and elderly group,while CAI was not statistically significant between the two groups(P=0.419).②The NREM stageⅠ(61.1±4.3)%in the junior group was significantly higher than that in the junior group(53.3±3.4)%.NREM stageⅡ(33.2±2.3)%and NREM stageⅢ+Ⅳ(4.3±1.3)%in the junior group were higher than those in the middle-aged group(29.2±3.9)%and stageⅢ+Ⅳ(2.6±0.9)%,while the percentage of REM stage and microarousal index were not statistically significant between the two groups.③Young OSA patients were associated with hypertension and 47.0% middle-aged and elderly patients were associated with hypertension.There was no statistical difference between the two groups in whether hypertension was associated with hypertension or not.Conclusion:The NREM phase is particularly susceptible to age,and age affects slow wave sleep.The sleep structure of middle-aged and older people demonstrates their sleep characteristics:reduced total sleep time,slow wave sleep,low sleep efficiency,and delayed sleep.The young people's nighttime hypoxia is more serious.AHI,ODI,OAI,MAI,ASaO_2 and other indicators are significantly higher than the middle-aged and elderly people,but the sleep structure 2 groups are similar,indicating that young people have strong sleep physiological compensation and Adjustment ability.
Objective:The aim of this study is to compare the night sleep hypoxia degree and sleep structure of young and middle-aged and elderly patients with OSA,so that PSG has more important application value.Method:A total of 438 patients diagnosed with OSA from February 2017 to January 2019 were selected,including 119 patients in the youth group with an average age of(28.5±5.1)years,and 319 patients in the middle and elderly group with an average age of(45.8±2.7)years.The results recorded by PSG in the two groups were retrospectively analyzed.Result:①The AHI,ODI,OAI,MAI and ASaO_2 of OSA patients in the junior group were significantly higher than those in the middle-aged and elderly group,while CAI was not statistically significant between the two groups(P=0.419).②The NREM stageⅠ(61.1±4.3)%in the junior group was significantly higher than that in the junior group(53.3±3.4)%.NREM stageⅡ(33.2±2.3)%and NREM stageⅢ+Ⅳ(4.3±1.3)%in the junior group were higher than those in the middle-aged group(29.2±3.9)%and stageⅢ+Ⅳ(2.6±0.9)%,while the percentage of REM stage and microarousal index were not statistically significant between the two groups.③Young OSA patients were associated with hypertension and 47.0% middle-aged and elderly patients were associated with hypertension.There was no statistical difference between the two groups in whether hypertension was associated with hypertension or not.Conclusion:The NREM phase is particularly susceptible to age,and age affects slow wave sleep.The sleep structure of middle-aged and older people demonstrates their sleep characteristics:reduced total sleep time,slow wave sleep,low sleep efficiency,and delayed sleep.The young people's nighttime hypoxia is more serious.AHI,ODI,OAI,MAI,ASaO_2 and other indicators are significantly higher than the middle-aged and elderly people,but the sleep structure 2 groups are similar,indicating that young people have strong sleep physiological compensation and Adjustment ability.
引文
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[14]MANDER B A,REID K J,DAVULURI V K,et al.Sleep and Human Aging[J].Neuron,2017,94:19-36.
[15]DANG-VU T T,DESSEILLES M,LAUREYS S,et al.Cerebral correlates of delta waves during non-REMsleep revisited[J].Neuroimage,2005,28:14-21.
[16]POLONIS K,SOMERS V K,BECARI C,et al,Moderate-to-severe obstructive sleep apnea is associated with telomere lengthening[J].Am J Physiol Heart Circ Physiol,2017,313:H1022-1030.
[2]BLACK J.Sleepiness and residual sleepiness in adults with obstructive sleep apnea[J].Respir Physiol Neurobiol,2003,136:211-220.
[3]中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].中华结核和呼吸杂志,2012,35(1):9-12.
[4]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志,2011,39(8):579-616.
[5]JAMES P T.Obesity:the worldwide epidemic[J].Clin Dermatol,2004,22:276-280.
[6]MURAKI I,TANIGAWA T,YAMAGISHI K,et al.Nocturnal intermittent hypoxia and metabolic syndrome;the effect of being overweight:the CIRCSstudy[J].J Atheroscler Thromb,2010,17:369-377.
[7]BHATTACHARJEE R,HAKIM F,GOZAL D.Sleep,sleep-disordered breathing and lipid homeostasis:translational evidence from murine models and children[J].Clin Lipidol,2012,7:203-214.
[8]TORRE-BOUSCOULET L,CASTORENA-MAL-DONADO A,BANOS-FLORES R,et al.Agreement between oxygen desaturation index and apnea-hypopnea index in adults with suspected obstructive sleep apnea at an altitude of 2240 m[J].Arch Bronconeumol,2007,43:649-654.
[9]MARCUS C L.Pathphysiology of children obstructive sleep apena:current concepts[J].Respir Physiol,2000,119:143-154.
[10]KRYGER M H,ROTH T,DEMENT W.Principles and practice of sleep medicine[M].4th ed.New York:Readmore,2005:24-24.
[11]LAZA Z I R,DJK D J,LAZAR A S,et al.Infraslow oscillations in human sleep spindle activity[J].J Neurosci,2019,316:22-34.
[12]ZHONG H H,YU B,LUO D,et al.Roles of aging in sleep[J].Neurosci Biobehav Rev,2019,98:177-184.
[13]LIN C Y,HO C S,TSAI W C,et al.Different effects of apnea during rapid eye movement period on peripheral arterial stiffness in obstructive sleep apnea[J].Atherosclerosis,2018,269:166-171.
[14]MANDER B A,REID K J,DAVULURI V K,et al.Sleep and Human Aging[J].Neuron,2017,94:19-36.
[15]DANG-VU T T,DESSEILLES M,LAUREYS S,et al.Cerebral correlates of delta waves during non-REMsleep revisited[J].Neuroimage,2005,28:14-21.
[16]POLONIS K,SOMERS V K,BECARI C,et al,Moderate-to-severe obstructive sleep apnea is associated with telomere lengthening[J].Am J Physiol Heart Circ Physiol,2017,313:H1022-1030.