서파수면이 유지되는 중증 폐쇄성 수면무호흡증 환자의 특성 분석
Characteristics of Patients With Severe Obstructive Sleep Apnea Who Maintain Slow-Wave Sleep
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives Obstructive sleep apnea (OSA) is a complex sleep-related re-spiratory disorder with various pathophysiology and clinical manifestations. Diagnosis andtreatment considering only the number of respiratory events, such as sleep duration, may havelimitations. The purpose of this study is to analyze the clinical and polysomnography (PSG)characteristics of patients with severe OSA in whom slow wave sleep (SWS) was well-main-tained. Subjects and Method This study retrospectively analyzed 203 patients who underwentPSG due to suspected OSA. Severe OSA patients were classified into a SWS maintainedgroup (SWS≥15%) and a SWS reduced group (SWS<15%), and their clinical records, PSG re-sults, and heart rate variability (HRV) were compared. Results The SWS maintained group (n=27), compared to the SWS reduced group (n=58),had a significantly longer total sleep time ( p=0.027) and lower wake after sleep onset ( p=0.001), rapid eye movoement (REM) latency ( p=0.007), non-supine apnea-hypopnea index(A HI, p=0.006), non-REM AHI ( p<0.001), arousal index ( p<0.001) and Epworth SleepinessScale ( p=0.048). In addition, the SWS maintained group had a significantly low value in verylow frequency in HRV than that of the SWS reduced group ( p=0.046). Conclusion The SWS maintained group in the severe OSA showed better PSG and HRV re-sults and reduced daytime sleepiness than those of the SWS reduced group.
Abstract
Background and Objectives Obstructive sleep apnea (OSA) is a complex sleep-related re-spiratory disorder with various pathophysiology and clinical manifestations. Diagnosis andtreatment considering only the number of respiratory events, such as sleep duration, may havelimitations. The purpose of this study is to analyze the clinical and polysomnography (PSG)characteristics of patients with severe OSA in whom slow wave sleep (SWS) was well-main-tained. Subjects and Method This study retrospectively analyzed 203 patients who underwentPSG due to suspected OSA. Severe OSA patients were classified into a SWS maintainedgroup (SWS≥15%) and a SWS reduced group (SWS<15%), and their clinical records, PSG re-sults, and heart rate variability (HRV) were compared. Results The SWS maintained group (n=27), compared to the SWS reduced group (n=58),had a significantly longer total sleep time ( p=0.027) and lower wake after sleep onset ( p=0.001), rapid eye movoement (REM) latency ( p=0.007), non-supine apnea-hypopnea index(A HI, p=0.006), non-REM AHI ( p<0.001), arousal index ( p<0.001) and Epworth SleepinessScale ( p=0.048). In addition, the SWS maintained group had a significantly low value in verylow frequency in HRV than that of the SWS reduced group ( p=0.046). Conclusion The SWS maintained group in the severe OSA showed better PSG and HRV re-sults and reduced daytime sleepiness than those of the SWS reduced group.
참고문헌 (23)
- Bristow JD, "Cardiovascular and respiratory changes during sleep in normal and hypertensive subjects", Cardiovasc Res, 3(4), pp.476~485 (1969)
- Partinen M, "Long-term outcome for obstructive sleep apnea syndrome patients : Mortality", Chest, 94(6), pp.1200~1204 (1988)
- Stansbury RC, "Clinical manifestations of sleep apnea", J Thorac Dis, 7(9), pp.E298~310 (2015)
- in Peruvian patients : A case-control study-a preliminary report, "Sleep Sci", 2015, 31~35
- Hamaoka T, "Different prognosis between severe and very severe obstructive sleep apnea patients; five year outcomes", J Cardiol, 76(6), pp.573~579 (2020)
- Spiegel R, "Significance of slow wave sleep : Considerations from a clinical viewpoint", Sleep, 9(1), pp.66~79 (1986)
- Raison CL, "Chronic interferon-alpha administration disrupts sleep continuity and depth in patients with hepatitis C: Association with fatigue, motor slowing, and increased evening cortisol", Biol Psychiatry, 68(10), pp.942~949 (2010)
- Redline S, "The effects of age, sex, ethnicity, and sleep-disordered breathing on sleep architecture", Arch Intern Med, 164(4), pp.406~418 (2004)
- Ohayon MM, "Metaanalysis of quantitative sleep parameters from childhood to old age in healthy individuals : Developing normative sleep values across the human lifespan", Sleep, 27(7), pp.1255~1273 (2004)
- Berry RB, "Rules for scoring respiratory events in sleep: Update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the sleep apnea definitions task force of the American Academy of Sleep Medicine", J Clin Sleep Med, 8(5), pp.597~619 (2012)
- Berry RB, "A transition to the American Academy of Sleep Medicinerecommended hypopnea definition in adults : Initiatives of the hypopnea scoring rule task sorce", J Clin Sleep Med, 18(5), pp.1419~1425 (2022)
- Ayas NT, "Update in sleep medicine 2014", Am J Respir Crit Care Med, 192(4), pp.415~420 (2015)
- Ye L, "The different clinical faces of obstructive sleep apnoea : A cluster analysis", Eur Respir J, 44(6), pp.1600~1607 (2014)
- Antonaglia C, "Obstructive sleep apnea syndrome in non-obese patients", Sleep Breath, 26(2), pp.513~518 (2022)
- Zinchuk AV, "Phenotypes in obstructive sleep apnea: A definition, examples and evolution of approaches", Sleep Med Rev, 35, pp.113~123 (2017)
- Cygankiewicz I, "Heart rate variability", Handb Clin Neurol, 117, pp.379~393 (2013)
- Thomas RJ, "An electrocardiogram-based technique to assess cardiopulmonary coupling during sleep", Sleep, 28(9), pp.1151~1161 (2005)
- Noda A, "Very low frequency component of heart rate variability as a marker for therapeutic efficacy in patients with obstructive sleep apnea : Preliminary study", J Res Med Sci, 24, pp.84~ (2019)
- 김민우, "중증 및 중등도 폐쇄성 수면무호흡증 환자에서 양압기 압력측정 직후 심박수와 심박변이도 분석", 대한이비인후-두경부외과학회지, 65(10), pp.594~601 (2022), 대한이비인후과학회[DOI]
- Walker MP, "The role of slow wave sleep in memory processing", J Clin Sleep Med, 5(2 Suppl), pp.S20~6 (2009)
- Backhaus J, "Impaired declarative memory consolidation during sleep in patients with primary insomnia : Influence of sleep architecture and nocturnal cortisol release", Biol Psychiatry, 60(12), pp.1324~1330 (2006)
- Baguet JP, "Update on hypertension management : Obstructive sleep apnea and hypertension", J Hypertens, 24(1), pp.205~208 (2006)
- Ren R, "Interaction between slow wave sleep and obstructive sleep apnea in prevalent hypertension", Hypertension, 75(2), pp.516~523 (2020)