혼합호흡형태를 가진 폐쇄수면무호흡 환자에서 수면무호흡의 특성
Characteristics of Sleep Apnea in Obstructive Sleep Apnea Patients with Mixed Breathing Patterns
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Abstract
Background: Varieties of mixed breathing patterns such as mixed or central sleep apnea in patients with obstructive sleep apnea (OSA) may observed during PSG. Our object is to compare the general feature and sleep apnea characteristics between OSA with and without mixed breathing pattern. Method: Total 244 patients who were diagnosed as OSA [apena-hypopnea index (AHI) ≥5/hr] were studied retrospectively. Mixed breathing pattern was defined as mixed apnea index plus central apnea index (MCAI) with ≥5/hr (Mix-OSA). Non-mix-OSA was defined with MCAI with <5/hr. Central sleep apnea syndrome was excluded. We investigated differences of the distribution and shifting of apnea index across sleep stage, position and sleep time between Mix-OSA and Non-mix-OSA group. Results: The prevalence of Mix-OSA was 42 of 244 OSA patients (17.2%). There were no significant differences in demographics except higher AHI in Mix-OSA group. Mix-OSA showed a significant increment of MCAI and hypopnea index during NREM sleep while Non-mix-OSA showed increased obstructive apnea index (OAI) in REM sleep period. In both groups, supine body position was related to high OAI. There were no meaningful differences in sleep apnea according to the timing of sleep in both groups. Conclusion: OSA patients with mixed breathing pattern had more severe OSA than Non-mix-OSA. There were some significant differences in sleep apnea characteristics between OSA with and without mixed breathing pattern. However, their clinical significance still remains unclear.
참고문헌 (19)
- Young T, "The occurrence of sleep-disordered breathing among middle-aged adults", N Engl J Med, 328, pp.1230~1235 (1993)
- Young T, "Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study", Arch Intern Med, 162, pp.893~900 (2002)
- Punjabi NM, "Sleep-disordered breathing and mortality: a prospective cohort study", PLoS Med, 6, pp.e1000132~ (2009)
- "Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force", Sleep, 22, pp.667~689 (1999)
- Ayappa I, "The upper airway in sleep: physiology of the pharynx", Sleep Med Rev, 7, pp.9~33 (2003)
- Patil SP, "Neuromechanical control of upper airway patency during sleep", J Appl Physiol (1985), 102, pp.547~556 (2007)
- Younes M, "Contributions of upper airway mechanics and control mechanisms to severity of obstructive apnea", Am J Respir Crit Care Med, 168, pp.645~658 (2003)
- Cherniack NS, "Respiratory dysrhythmias during sleep", N Engl J Med, 305, pp.325~330 (1981)
- Buysse DJ, "The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research", Psychiatry Res, 288, pp.193~213 (1989)
- Johns MW, "A new method for measuring daytime sleepiness: the Epworth sleepiness scale", Sleep, 14, pp.540~545 (1991)
- Yamauchi M, "Differences in breathing patterning during wakefulness in patients with mixed apnea-dominant vs obstructive-dominant sleep apnea", Chest, 140, pp.54~61 (2011)
- Thomas RJ, "Obstructive sleep-disordered breathing with a dominant cyclic alternating pattern--a recognizable polysomnographic variant with practical clinical implications", Sleep, 27, pp.229~234 (2004)
- Robin IG, "Snoring", Proc R Soc Med, 41, pp.151~153 (1948)
- Ravesloot MJ, "The undervalued potential of positional therapy in position-dependent snoring and obstructive sleep apnea-a review of the literature", Sleep Breath, 17, pp.39~49 (2013)
- van Kesteren ER, "Quantitative effects of trunk and head position on the apnea hypopnea index in obstructive sleep apnea", Sleep, 34, pp.1075~1081 (2011)
- Tkacova R, "Overnight shift from obstructive to central apneas in patients with heart failure:role of PCO2 and circulatory delay", Circulation, 103, pp.238~243 (2001)
- Iber C, "A possible mechanism for mixed apnea in obstructive sleep apnea", Chest, 89, pp.800~805 (1986)
- Smith PL, "The effects of oxygen in patients with sleep apnea", Am Rev Respir Dis, 130, pp.958~963 (1984)
- Gold AR, "A shift from central and mixed sleep apnea to obstructive sleep apnea resulting from low-flow oxygen", Am Rev Respir Dis, 132, pp.220~223 (1985)
