近二十年来阻塞性睡眠呼吸暂停疾病严重程度的趋势:关于VA圣地亚哥体验的最新情况
Brandon Nokes1,2, Tania Zamora3, Yzabel Velazquez3
1Sleep Medicine Section, Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA.
概括
阻塞性睡眠呼吸暂停 (OSA) 的严重程度总体上有所下降,轻度的OSA变得越来越普遍. 这凸显了除了持续正气道压力 (CPAP) 之外的替代治疗方法的需要,以提高患者的坚持和有效性.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 弗吉尼亚州圣地亚哥医疗保健系统的睡眠计划已经为其家庭睡眠呼吸暂停测试 (HSAT) 计划维护了超过二十年的患者数据库.
- 之前对12500多名患者 (2004-2013) 的分析表明,严重阻塞性睡眠呼吸暂停 (OSA) 减少,轻度睡眠暂停增加.
- 最近的一次持续正气道压力 (CPAP) 供应危机促使HSAT数据库重新评估.
研究的目的:
- 重新检查HSAT数据库,以评估OSA严重性的趋势.
- 评估最近事件,如2021年CPAP危机对OSA诊断和治疗的影响.
主要方法:
- 2018年至2022年期间进行的8928项诊断性HSAT睡眠研究的回顾性审查.
- 从不同时间段的呼吸暂停-呼吸暂停指数 (AHI) 数据的比较 (2004-2013年与2019-2022年).
主要成果:
- 整体平均呼吸暂停-呼吸暂停指数 (AHI) 从2004年的40.4小时显著下降到2022年的24.3小时 (p < .001).
- 从2004年至2013年,平均AHI从2008年开始显著下降.
- 在2019-2022年间,平均AHI没有显著差异.
结论:
- 研究结果表明,OSA转向较不严重的OSA,轻度OSA是最常见的诊断.
- 轻度OSA的高患病率,通常与较低的积极气道压力 (PAP) 治疗的坚持有关,强调了探索非PAP治疗替代方案的重要性.
- 这些趋势对优化OSA管理策略有重大影响.
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