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在实验室的多睡眠测试通过改变身体位置而使阻塞性睡眠呼吸暂停恶化,而不是在家进行测试

Raquel Chartuni Pereira Teixeira¹, Michel Burihan Cahali¹

¹Department of Otolaryngology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 255, sala 6167, São Paulo 05403-000, SP, Brazil.

Sensors (Basel, Switzerland)

|May 11, 2024

概括

与实验室测试相比,家庭睡眠呼吸暂停测试低估了阻塞性睡眠暂停 (OSA) 的严重程度. 在实验室的多梦镜可能会因身体位置的变化而增加OSA的严重程度,特别是在严重的病例中.

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

背景情况:

家庭睡眠呼吸暂停测试 (多睡眠学类型3,PSG3) 与实验室多睡眠学 (PSG1) 相比,往往低估了呼吸事件.
在家庭环境中缺少头部电极可能会导致更自然的身体定位,可能减少阻塞性睡眠呼吸暂停 (OSA) 的严重程度.
这种低估可能独立于由于缺少兴奋得分而错过的低眠症.

研究的目的:

调查睡眠评分和身体定位对家庭和实验室睡眠测试之间的OSA严重性评估的影响.
确定患者亚组,其中OSA严重程度在PSG1和PSG3之间显著不同.
为了确定测试位置是否会影响身体位置和OSA评估.

主要方法:

怀疑OSA的患者接受了随机的PSG1和PSG3.
减少的多睡眠分析排除了PSG1的睡眠和兴奋评分,以模仿家庭测试条件.
根据PSG1和PSG3之间的临床相关差异 (呼吸暂停-呼吸暂停指数变化≥15) 来对患者进行分类.

主要成果:

除了睡眠评分,在实验室测试中减少了OSA的严重程度,类似于家庭测试结果.
具有临床相关差异的患者在实验室内有更严重的OSA (AHI 42.5对20.2,p=0.002),这种差异在家庭测试中消失了.
在临床上相关的差异组中,观察到卧卧式呼吸暂停-卧卧式呼吸暂停指数和卧卧式时间的较大变化,表明对身体位置的局部特异性影响.

结论:

在实验室的多睡眠学可能会人工膨胀OSA严重程度在一些患者由于改变的身体定位.
测试地点似乎会影响OSA的评估,特别是在患有更严重疾病的患者中.
家庭和实验室设置之间的身体位置变化显著影响OSA严重性评估.

关键词:

呼吸暂停呼吸暂停指数家庭睡眠呼吸暂停测试测试在实验室中的多睡眠学.阻塞性睡眠呼吸暂停 (SOP) 的情况.躺卧式床 (supine decubitus) - - 这是一种床.

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