{"title":"有意识镇静下胃肠内窥镜偶然诊断的阻塞性睡眠呼吸暂停严重程度。","authors":"Kosuke Kashiwabara, Fujiho Tanaka, Takenori Yamanouchi, Motoki Yoshida, Toshiaki Yoshida, Masayuki Ando","doi":"10.1007/s11325-025-03289-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>It remains unclear whether patients diagnosed as having obstructive sleep apnea (OSA) incidentally while undergoing gastrointestinal endoscopy under conscious sedation (GE-CS) have predominantly mild disease.</p><p><strong>Materials and methods: </strong>We evaluated differences in the disease characteristics, severity and treatments received between patients who were suspected as having OSA during GE-CS (GE group, n = 56) and patients who visited our hospital with a history of OSA-related symptoms (SY group, n = 123).</p><p><strong>Results: </strong>The median age of patients, percentage of men and percentage of patients with obesity were 54 years, 68%, and 21% in the GE group and 51 years, 78%, and 31% in the SY group, respectively. The percentages of patients with mild, moderate, and severe OSA were 18%, 36%, and 43% in the GE group and 30%, 17%, and 39% in the SY group, respectively. The percentages of patients with subjective symptoms (e.g., daytime sleepiness/tiredness, 61% vs. 75%, p = 0.056) and scores on the Epworth sleepiness scale of ≥ 11 (18% vs. 37%, p = 0.009) were lower in the GE group, whereas there was no difference in the proportion of patients with objective symptoms (e.g., loud snoring or apnea, 70% vs. 70%) between the two groups. Patients with moderate-to-severe OSA who received continuous positive airway pressure (CPAP) therapy were fewer in the GE group (34% vs. 65%, p = 0.001).</p><p><strong>Conclusion: </strong>A large percentage of patients with OSA diagnosed incidentally while undergoing GE-CS had moderate-to-severe disease but refused CPAP as they often had few subjective symptoms.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":"29 2","pages":"139"},"PeriodicalIF":2.0000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Severity of obstructive sleep apnea diagnosed incidentally during gastrointestinal endoscopy under conscious sedation.\",\"authors\":\"Kosuke Kashiwabara, Fujiho Tanaka, Takenori Yamanouchi, Motoki Yoshida, Toshiaki Yoshida, Masayuki Ando\",\"doi\":\"10.1007/s11325-025-03289-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>It remains unclear whether patients diagnosed as having obstructive sleep apnea (OSA) incidentally while undergoing gastrointestinal endoscopy under conscious sedation (GE-CS) have predominantly mild disease.</p><p><strong>Materials and methods: </strong>We evaluated differences in the disease characteristics, severity and treatments received between patients who were suspected as having OSA during GE-CS (GE group, n = 56) and patients who visited our hospital with a history of OSA-related symptoms (SY group, n = 123).</p><p><strong>Results: </strong>The median age of patients, percentage of men and percentage of patients with obesity were 54 years, 68%, and 21% in the GE group and 51 years, 78%, and 31% in the SY group, respectively. The percentages of patients with mild, moderate, and severe OSA were 18%, 36%, and 43% in the GE group and 30%, 17%, and 39% in the SY group, respectively. The percentages of patients with subjective symptoms (e.g., daytime sleepiness/tiredness, 61% vs. 75%, p = 0.056) and scores on the Epworth sleepiness scale of ≥ 11 (18% vs. 37%, p = 0.009) were lower in the GE group, whereas there was no difference in the proportion of patients with objective symptoms (e.g., loud snoring or apnea, 70% vs. 70%) between the two groups. 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引用次数: 0
摘要
背景:目前尚不清楚在清醒镇静(GE-CS)下进行胃肠内镜检查时偶然诊断为阻塞性睡眠呼吸暂停(OSA)的患者是否主要为轻度疾病。材料和方法:我们评估了在GE- cs期间疑似OSA患者(GE组,n = 56)和有OSA相关症状史来我院就诊的患者(SY组,n = 123)在疾病特征、严重程度和所接受治疗方面的差异。结果:GE组患者中位年龄为54岁,男性比例为68%,肥胖患者比例为21%;SY组患者中位年龄为51岁,男性比例为78%,肥胖患者比例为31%。GE组轻度、中度、重度OSA患者比例分别为18%、36%、43%,SY组为30%、17%、39%。GE组出现主观症状(如白天嗜睡/疲倦,61%比75%,p = 0.056)和Epworth嗜睡量表评分≥11分(18%比37%,p = 0.009)的患者比例较低,而两组出现客观症状(如大声打鼾或呼吸暂停,70%比70%)的患者比例无差异。GE组接受持续气道正压通气(CPAP)治疗的中重度OSA患者较少(34% vs. 65%, p = 0.001)。结论:在接受GE-CS时偶然诊断的OSA患者中,有很大一部分是中重度疾病,但由于他们通常没有什么主观症状而拒绝CPAP。
Severity of obstructive sleep apnea diagnosed incidentally during gastrointestinal endoscopy under conscious sedation.
Background: It remains unclear whether patients diagnosed as having obstructive sleep apnea (OSA) incidentally while undergoing gastrointestinal endoscopy under conscious sedation (GE-CS) have predominantly mild disease.
Materials and methods: We evaluated differences in the disease characteristics, severity and treatments received between patients who were suspected as having OSA during GE-CS (GE group, n = 56) and patients who visited our hospital with a history of OSA-related symptoms (SY group, n = 123).
Results: The median age of patients, percentage of men and percentage of patients with obesity were 54 years, 68%, and 21% in the GE group and 51 years, 78%, and 31% in the SY group, respectively. The percentages of patients with mild, moderate, and severe OSA were 18%, 36%, and 43% in the GE group and 30%, 17%, and 39% in the SY group, respectively. The percentages of patients with subjective symptoms (e.g., daytime sleepiness/tiredness, 61% vs. 75%, p = 0.056) and scores on the Epworth sleepiness scale of ≥ 11 (18% vs. 37%, p = 0.009) were lower in the GE group, whereas there was no difference in the proportion of patients with objective symptoms (e.g., loud snoring or apnea, 70% vs. 70%) between the two groups. Patients with moderate-to-severe OSA who received continuous positive airway pressure (CPAP) therapy were fewer in the GE group (34% vs. 65%, p = 0.001).
Conclusion: A large percentage of patients with OSA diagnosed incidentally while undergoing GE-CS had moderate-to-severe disease but refused CPAP as they often had few subjective symptoms.
期刊介绍:
The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep.
Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.