Prevalence and Predicting Factors of Complex Sleep Apnea in Patients with Obstructive Sleep Apnea Syndrome

Journal of Korean Sleep Research Society Pub Date : 2013-12-26 DOI:10.13078/JKSRS.13010

H. Ryu, Eun Mi Lee, Gha-Hyun Lee, Bomi Kim, Sang-Ahm Lee

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引用次数: 2

Abstract

Address for correspondence Sang-Ahm Lee, MD, PhD Division of Epilepsy and Sleep, Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea Tel: +82-2-3010-3445 Fax: +82-2-474-4691 E-mail: salee@amc.seoul.kr Objectives: Some patients with obstructive sleep apnea syndrome (OSAS) experience development of central sleep apnea (CSA) during continuous positive airway pressure (CPAP) application (complex sleep apnea, compSA). We reviewed the prevalence and polysomnographic characteristics of compSA in patients with a primary diagnosis of OSAS. Methods: Total 198 patients with OSAS who performed CPAP titration at the Asan Medical Center were studied retrospectively from year 2006 to 2009. compSA was defined as presenting central sleep apnea ≥5 /h, during CPAP titration to eliminate upper airway obstruction. Demographic profiles and polysomnography (PSG) variables were compared between compSA and NoncompSA. Results: The prevalence of compSA was 17 of 198 (8.6%) with male predominance (n=17). Among compSA, 11 patients showed persistent CSA during entire titration and 6 patients showed newly developed CSA above certain pressure level (mean 7.2 cmH2O). At near optimized CPAP levels, obstructive sleep apnea index (OAI) was not significantly different between two groups (compSA; 0.52±0.74 /h vs. NoncompSA; 0.32±0.80 /h) but the level of apnea hypopnea index (AHI), mixed apnea index (MAI), central apnea index (CAI), and hypopnea index (HI) were greater in compSA than Non-compSA (compSA: AHI; 15.23±9.85 /h, MAI; 0.97±1.83 /h, CAI; 8.22±7.96 /h, HI; 5.52±4.98 /h vs. Non-compSA: AHI; 2.20±2.25 /h, MAI; 0.08±0.27 /h, CAI; 0.48±0.89 /h, HI; 5.52±4.98 /h). At baseline PSG, the value of CAI and MAI was higher in compSA (CAI; 3.78±3.92 /h vs. 1.03±1.97 /h, MAI; 6.71±7.50 /h vs. 4.33±9.59 /h) but there were no differences in AHI, OAI, HI, and demographic profiles between two groups. Conclusions: In this study, early indicators of developing compSA in baseline PSG was CAI and MAI. J Korean Sleep Res Soc 2013;10:51-55

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阻塞性睡眠呼吸暂停综合征患者复杂睡眠呼吸暂停的患病率及预测因素

通讯地址:韩国首尔松坡区奥林匹克路43号88号蔚山大学医学院峨山医学中心神经内科癫痫睡眠科李尚安医学博士电话:+82-2-3010-3445传真:+82-2-47 -4691 E-mail: salee@amc.seoul.kr一些阻塞性睡眠呼吸暂停综合征(OSAS)患者在持续气道正压通气(CPAP)应用过程中出现中枢性睡眠呼吸暂停(CSA)(复杂睡眠呼吸暂停，compSA)。我们回顾了初步诊断为OSAS的患者中compSA的患病率和多导睡眠图特征。方法:对2006 ~ 2009年峨山医院行CPAP滴定术的198例OSAS患者进行回顾性分析。compSA定义为在CPAP滴定消除上呼吸道阻塞期间出现中枢性睡眠呼吸暂停≥5次/小时。比较了compSA和非compSA的人口统计资料和多导睡眠图(PSG)变量。结果:198例患者中有17例(8.6%)患compSA，其中男性占优势(n=17)。在compSA中，11例患者在整个滴定过程中出现持续性CSA, 6例患者在一定压力水平以上出现新发CSA(平均7.2 cmH2O)。在接近优化CPAP水平时，两组间阻塞性睡眠呼吸暂停指数(OAI)无显著差异(compSA;0.52±0.74 /h;0.32±0.80 /h)，但compSA组的呼吸暂停低通气指数(AHI)、混合性呼吸暂停指数(MAI)、中枢性呼吸暂停指数(CAI)和低通气指数(HI)水平均高于非compSA组(compSA: AHI;15.23±9.85 /h, MAI;0.97±1.83 /h, CAI;8.22±7.96 /h, HI;5.52±4.98 /h vs.非compsa: AHI;2.20±2.25 /h, MAI;0.08±0.27 /h, CAI;0.48±0.89 /h, HI;5.52±4.98 /小时)。在PSG基线时，compSA患者的CAI和MAI值较高(CAI;MAI: 3.78±3.92 /h vs. 1.03±1.97 /h;(6.71±7.50 /h vs. 4.33±9.59 /h)，但两组之间的AHI、OAI、HI和人口统计学特征无差异。结论:在本研究中，基线PSG中发生compSA的早期指标是CAI和MAI。[J] .睡眠科学学报，2013;10:51-55

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Journal of Korean Sleep Research Society

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