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在患有阻塞性睡眠呼吸暂停的患者中,针对持续 (隔离) 的REM睡眠而没有心脏衰竭的多睡眠学生物标志物

Aysegul Akkan Suzan¹, Didem Tezen¹, Recep Dursun Onar¹

¹Sleep and Disorders Unit, Division of Clinical Neurophysiology, Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University- Cerrahpasa, Istanbul, Turkiye.

|May 14, 2025

概括

近40%的阻塞性睡眠呼吸暂停患者在PAP治疗后持续存在的REM睡眠没有动 (RSWA). 这种持续的RSWA可能标志着iRSWA,一种潜在的神经退行生物标志物,特定的PSG生物标志物有助于诊断.

科学领域:

神经学神经学
睡眠医学睡眠医学
肺部病理学肺部病理学

背景情况:

阻塞性睡眠呼吸暂停 (OSA) 和没有的REM睡眠 (RSWA) 有一个复杂的,不完全理解的关系.
RSWA可能会减轻气道崩,但可以模仿REM睡眠行为障碍 (RBD),并表明神经退行.
在OSA患者治疗正气道压力 (PAP) 后,确定持续孤立RSWA (iRSWA) 的预测因素至关重要.

研究的目的:

确定在接受PAP治疗的OSA患者中持续性iRSWA的患病率和特征.
为了确定持续性iRSWA的临床和多睡眠学 (PSG) 预测因素.
探索持久性RSWA作为神经退行性疾病的原发性生物标志物的潜力.

主要方法:

对297名RSWA的OSA患者进行了回顾性分析,这些患者接受了PSG与PAP定位.
使用视觉和自动化方法进行RSWA评估.
用ROC分析进行预测因子识别,比较持久RSWA和没有持久RSWA的患者之间的临床和PSG参数.

主要成果:

持续的RSWA在41.5%的患者中被发现.
高龄,较高的周期性四肢运动指数 (PLMSI) 和较低的呼吸暂停-呼吸暂停指数 (AHI) 与持续的RSWA相关.
四个PSG生物标志物 (RSWA/REM持续时间,RSWA/tAHD在REM中, tAHD在REM/REM持续时间,REM失眠指数) 强烈预测了持续的RSWA.

结论:

在OSA患者中,尽管接受了PAP治疗,但RSWA的很大一部分仍然存在,这表明它可能代表iRSWA.
持续的RSWA可以作为神经退行性疾病的前兆生物标志物.
已识别的PSG生物标志物可能会增强iRSWA与OSA相关RSWA的分化,有助于早期诊断和预后.

关键词:

神经退行发生神经退行.阻塞性睡眠呼吸暂停症是什么多重睡眠学术 (Polysomnography) 是一种多重睡眠学术.气道压力为正,气道压力为正.在REM中,REM的atonia指数是指数.雷姆睡眠行为障碍雷姆睡眠行为障碍快速眼动睡眠没有动.

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