使用扩展诊断标准可以减轻睡眠呼吸障碍诊断中的性别差异
Kenna Haile1, Monica Mungarwadi1, Nesrine Adly Ibrahim2
1Wayne State University School of Medicine, Detroit, Michigan.
概括
美国睡眠医学学会.
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
- 性别健康差异 性别健康差异
背景情况:
- 睡眠呼吸障碍 (SDB) 诊断标准历史上基于男性生理学.
- 目前的支付者准则可能会使用4%的氧气不和 (AHI-4) 定义来定义失眠,这与美国睡眠医学学会的3%氧气不和或唤醒 (AHI-3A) 标准不同.
- 在SDB诊断和管理中基于性别的差异是一个重大问题.
研究的目的:
- 在临床环境中检查AHI-4与AHI-3A标准的诊断含义.
- 评估这些不同的定义如何影响男性和女性的SDB诊断率.
- 在SDB诊断中识别潜在的基于性别的差异.
主要方法:
- 2019年,从一个单一的睡眠障碍中心对多睡眠记录报告的回顾性审查.
- 使用AHI-4和AHI-3A标准对所有多睡眠记录进行评分.
- 分析了279名女性和152名男性的数据.
主要成果:
- 根据AHI-3A标准,两种性别的诊断均显著增加:女性为30.4% (P = .001),男性为21.7% (P = .006).
- 与AHI-4相比,女性在AHI-3A的轻度和中度SDB诊断中出现了较大的增加.
- 与AHI-4相比,男性在AHI-3A的严重SDB诊断中增加了更多.
结论:
- 根据AHI-3A下定义,它更符合女性SDB病理生理学,导致更高的诊断率.
- AHI-4标准可能会延续基于性别的诊断差异,可能会让有症状的女性没有被诊断和治疗.
- 实施AHI-3A标准可以改善SDB诊断和管理性别平等.
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