Characteristics of Sleep Apnea in Obstructive Sleep Apnea Patients with Mixed Breathing Patterns

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

Objectives: Varieties of mixed breathing patterns such as mixed or central sleep apnea in patients with obstructive sleep apnea (OSA) may observed during polysomnography. Our object is to compare the general feature and sleep apnea characteristics between OSA with and without mixed breathing pattern. Methods: Total 244 patients who were diagnosed as OSA [apnea-hypopnea index (AHI) ≥5 /h] were studied retrospectively. Mixed breathing pattern was defined as mixed apnea index plus central apnea index (MCAI) with ≥5 /h (Mix-OSA). OSA without mixed breathing pattern (Non-mix-OSA) was defined with MCAI with <5 /h. Central sleep apnea syndrome was excluded. We investigated differences of the distribution and shifting of apnea index across sleep stage, position and sleep time between Mix-OSA and Non-mix-OSA group. Results: The prevalence of Mix-OSA was 42 of 244 OSA patients (17.2%). There were no significant differences in demographics except higher AHI in Mix-OSA group. Mix-OSA showed a significant increment of MCAI and hypopnea index during non rapid eye movement sleep while Non-mix-OSA showed increased obstructive apnea index (OAI) in rapid eye movement sleep period. In both groups, supine body position was related to high OAI. There were no meaningful differences in sleep apnea according to the timing of sleep in both groups. Conclusions: OSA patients with mixed breathing pattern had more severe OSA than Non-mix-OSA. There were some significant differences in sleep apnea characteristics between OSA with and without mixed breathing pattern. However, their clinical significance still remains unclear. J Korean Sleep Res Soc 2013;10:45-50
混合呼吸方式阻塞性睡眠呼吸暂停患者睡眠呼吸暂停的特点
目的:多导睡眠图可观察到阻塞性睡眠呼吸暂停(OSA)患者混合性或中枢性睡眠呼吸暂停等多种混合性呼吸模式。我们的目的是比较有和没有混合呼吸方式的OSA的一般特征和睡眠呼吸暂停的特征。方法:对244例确诊为OSA[呼吸暂停低通气指数(AHI)≥5 /h]的患者进行回顾性分析。混合型呼吸模式定义为混合呼吸暂停指数加中央呼吸暂停指数(MCAI)≥5 /h (Mix-OSA)。MCAI <5 /h为无混合性呼吸模式OSA (Non-mix-OSA)。排除中枢性睡眠呼吸暂停综合征。我们研究了混合osa组和非混合osa组在睡眠阶段、体位和睡眠时间中呼吸暂停指数的分布和变化的差异。结果:244例OSA患者中,混合型OSA发生率为42例(17.2%)。除Mix-OSA组AHI较高外,统计学差异无统计学意义。混合型osa在非快速眼动睡眠时MCAI和低通气指数显著升高,非混合型osa在快速眼动睡眠时阻塞性呼吸暂停指数(OAI)显著升高。在两组中,仰卧位与高OAI有关。根据睡眠时间不同,两组患者的睡眠呼吸暂停症状无显著差异。结论:混合呼吸方式的OSA患者比非混合呼吸方式的OSA患者更严重。伴有和不伴有混合呼吸方式的OSA患者睡眠呼吸暂停特征有显著性差异。然而,其临床意义尚不清楚。[J]睡眠研究,2013;10:45-50
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