阻塞性睡眠呼吸暂停综合征对飞行员睡眠、情绪和主观生活质量的影响  

Effects of obstructive sleep apnea syndrome on pilot＇s sleepiness, mood and subjective quality of life

作　　者：余昳[1] 谭昌金[1] 张瞿璐[1] 武强[2] 濮捷[2] 杨长亮[3] 

机构地区：[1]广州军区武汉总医院空勤科,武汉430070 [2]广州军区武汉总医院神经内科,武汉430070 [3]广州军区武汉总医院耳鼻喉科,武汉430070

出　　处：《中华航空航天医学杂志》2011年第3期203-206,共4页Chinese Journal of Aerospace Medicine

摘　　要：目的探讨阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome，OSAS）对飞行员白天过度嗜睡（excessive daytime sleepiness，EDS）、情绪状态和主观生活质量（subjective qualityoflife，QOF）的影响。方法对经多导睡眠仪（polysomnography，PSG）监测诊断的54例OSAS飞行员和30例正常飞行员做人体测量、记录Epworth嗜睡量表评分（Epworth sleepinesss cale，ESS）、睡眠呼吸暂停生活质量指数（calgary sleep apnea quality of life index，SAQLI）和Zung抑郁自评量表（Zungself-rateddepression scale，SE,S），将所获资料进行描述和均数比较。结果OSAS飞行员中76．6％超重，20．3％肥胖；28．1％存有白天嗜睡，对日常工作及生活有明显影响；41．7％的患者抑郁，抑郁症状与白天嗜睡及疲劳有明显关系。比较正常飞行员和不同程度OSAS飞行员的体质指数、颈围、呼吸暂停低通气指数（sleep apneah ypopnea index，AHI）、ESS、SAQLI和SDS评分，差异均有统计学意义（F=6．28～270．29，P〈0.01）；进一步分析发现，SAQu和AHI在正常和轻度患者之间差异有统计学意义（P〈O．01），ESS在正常和轻度患者之间差异无统计学意义（P〉0．05），而在正常和中重度患者之间差异有统计学意义（P〈O．01）。本研究12例OSAS歼击机飞行员中9例轻度，3例中度，经减轻体重，复测PSG参数和ESS评分正常，均飞行合格；42例OSAS运输机飞行员中13例轻度，飞行合格；15例中度，经减轻体重，PSG参数和ESS评分正常，飞行合格；14例重度，其中8例经减轻体重症状好转飞行合格，6例尚在治疗中。结论OSAS飞行员常伴有白天过度嗜睡和抑郁情绪，其主观生活质量较正常者明显下降。中度及重度OSAS飞行员应进行干预治疗。Objective To suggest inTervention by investigating the eFfects of obstructive sleepapnea syndrome（OSAS） on pilot＇s sleepiness, mood and subjective quality ot lite. Methods Fiftyfour pilots, who were diagnosed as OSAS by polysomnography （PSG）, and 30 normal flying personnel were measured by anthropometry, Epworth Sleepiness Scale（ESS）, Calgary Sleep Apnea Quality of Life Index（SAQLI） and Zung self-rated depression scale （SDS）. Data were processed by descriptive review and mean valve comparison. Results Among OSAS pilots, 76.6% of them were oveweighed, while 20. 3% were obesity and 28. 1% showed excessive daytime sleepiness. Those significantly affected their work and life. 41. 7% OSAS pilots expressed depression or depression symptom, which indicated close correlation to excessive daytime sleepiness and fatigue. Comparisons of body mass index （BMI）, neck circumference, sleep apnea/hypopnea index （AHI）, the longest time of breathing disorder（BDLon）, ESS and SAQLI showed significant difference between OSAS and normal pilots （F= 6.28-270.29, P〈0.01）. Further analysis showed statistical difference between the normal and mild OSAS pilots on SAQLI and AHI （P〈0.01）. Even ESS had no significant difference with mild OSAS pilots（P）0.05） but with the moderate （P（0.01）. Twelve OSAS fighter pilots, including 9 mild and 3 moderate cases, got normal results in PSG and ESS test when they reduced weight, and then were qualified for flying. Among 42 OSAS transporter pilots, 13 mild cases were directly qualified while 15 moderate and 8 severe cases returned to the normal in PSG and ESS test by weight reduction and they passed the assessment for flying. Another 6 severe cases were in treatment. Conclusions OSAS pilots are usually with the symptoms of excessive daytime sleepiness and depression mood. Their subjective quality of life is significantly degraded as compared with the normal. It is suggested that necessary intervention should be considered especially to the moderate

关 键 词：睡眠呼吸暂停 阻塞性 嗜睡 生活质量 行为症状 

分 类 号：R766[医药卫生—耳鼻咽喉科]