阻塞性睡眠呼吸暂停是患有并发性失眠和睡眠暂停的个体的一个明显的生理内型
Elliot J Brooker1, Shane A Landry2, Luke D J Thomson2
1Turner Institute for Brain and Mental Health, School of Psychological Sciences.
Annals of the American Thoracic Society
|June 30, 2023
概括
与单独患有OSA的人相比,患有阻塞性睡眠呼吸暂停 (OSA) 和并发性失眠障碍 (COMISA) 的个人表现出较低的兴奋值和更稳定的呼吸. 这表明过度兴奋可能会导致COMISA患者的OSA严重程度.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统生理学 呼吸系统生理学
- 睡眠障碍 睡眠障碍 睡眠障碍
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 和失眠经常同时发生,这表明它们有共同的机制.
- 失眠对OSA病理生理学的影响仍未得到充分研究.
研究的目的:
- 为了比较四个关键的OSA内型,包括患有OSA和并发性失眠症 (COMISA) 患者和仅患有OSA的患者.
- 调查这些内型在COMISA患者OSA病变发生中的作用.
主要方法:
- 在34名COMISA患者和34名OSA患者的呼吸道流动模式上分析了多睡眠图像数据.
- 根据年龄,性别和BMI匹配的队列,具有轻度至重度的OSA (AHI 25.8 ± 2.0事件/小时).
- 测量OSA内型:上呼吸道折叠性,肌肉补偿,循环增益和兴奋值.
主要成果:
- COMISA患者的兴奋值显著降低 (p<0.001) 和上呼吸道的折叠性较低 (p<0.001).
- COMISA患者表现出更稳定的呼吸控制与较低的循环增益 (p=0.03).
- 唤醒值缓和了COMISA患者的可折叠性-OSA严重性关系.
结论:
- 低兴奋值是COMISA中普遍存在的内型,可能会增加OSA风险或严重程度.
- 较低的上呼吸道缩性表明,在COMISA相关的OSA中,解剖学因素不那么重要.
- 由失眠引起的有条件的过度兴奋可能会降低兴奋值,从而导致COMISA中OSA的发病.
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