폐쇄수면무호흡증후군 환자에서 복합수면무호흡의 유병률 및 예측인자
Prevalence and Predicting Factors of Complex Sleep Apnea in Patients with Obstructive Sleep Apnea Syndrome
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Abstract
Purpose : Some patients with OSA syndrome experience development of central sleep apnea(CSA) during CPAP application(complex sleep apnea; compSA). We reviewed the prevalence and polysomnographic characteristics of compSA in patients with a primary diagnosis of OSA syndrome. Method : Total 198 patients with OSA syndrome who performed CPAP titration at the Asan Medical Center were studied retrospectively from year 2006 to 2009. CompSA was defined as presenting central sleep apnea ≥5/hr, during CPAP titration to eliminate upper airway obstruction. Demographic profiles and PSG variables were compared between compSA and Non-compSA. Results: The prevalence of compSA was 17 of 198(8.6%) with male predominance(n=17). Among compSA, 11 patients showed persistent central sleep apnea(CSA) during entire titration and 6 patients showed newly developed CSA above certain pressure level(mean 7.2cmH2O). At near optimized CPAP levels, obstructive sleep apnea index(OAI) was not significantly different between two groups(compSA; 0.52±0.74/hr vs Non- compSA; 0.32±0.80/hr) but the level of AHI(apnea hypopnea index), MAI(mixed apnea index), CAI(central apnea index) and HI(hypopnea index) were greater in compSA than Non-compSA.(compSA; AHI;15.23±9.85/hr, MAI;0.97±1.83/hr, CAI;8.22 ±7.96/hr, HI;5.52±4.98/hr vs Non-compSA; AHI;2.20±2.25/hr, MAI;0.08± 0.27/hr, CAI;0.48±0.89/hr, HI;5.52±4.98/hr) At baseline PSG, the value of CAI and MAI was higher in compSA(CAI;3.78±3.92/hr vs 1.03±1.97/hr, MAI;6.71±7.50 vs 4.33±9.59) but there were no differences in AHI, OAI, HI and demographic profiles between two groups. Conclusion: In this study, early recognition of compSA in baseline PSG was CAI and MAI which revealed higher scores than Non-compSA.
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