主诉失眠患者伴发阻塞性睡眠呼吸暂停的临床特点  

Clinical characteristics of obstructive sleep apnea in patients with chief complaint of insomnia

作　　者：周蓉 张杨[1] 于周龙 孙伟[1] ZHOU Rong;ZHANG Yang;YU Zhoulong;SUN Wei(Peking University Sixth Hospital,Peking UIniversity Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Beijing 100083,China)

机构地区：[1]北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生重点实验室(北京大学),国家精神心理疾病临床医学研究中心,北京100083

出　　处：《中国心理卫生杂志》2021年第8期623-627,共5页Chinese Mental Health Journal

基　　金：国家重点研发计划项目资助(2018YFC1311600)。

摘　　要：目的:比较单纯失眠和失眠伴阻塞性睡眠呼吸暂停(OSA)的临床特点;分析失眠伴OSA的危险因素。方法:回顾分析以失眠为主诉住院且完成多导睡眠图(PSG)的患者455例。以PSG结果呼吸暂停低通气指数(AHI)≥5次/h为失眠伴OSA组(111例);以AHI <5次/h为单纯失眠组(344例)。比较两组的人口学特征、汉密顿焦虑评分、汉密顿抑郁评分、用药情况、性激素水平和PSG结果;采用logistic回归分析主诉失眠的患者伴发OSA的危险因素。结果:组间比较显示失眠伴OSA组与单纯失眠组相比年龄大、男性比例高、卵泡刺激素水平高、催乳素、雌二醇和孕酮水平低,N3期潜伏期长、N1期比例高、N3期比例低、总睡眠时间短、睡眠效率低、最低氧饱和度低、周期性腿动指数高、鼾声事件多、觉醒指数高(均P <0.05)。Logistic回归分析显示,年龄大(OR=1.03~1.08)、鼾声事件多(OR=1.01)是失眠患者伴OSA的危险因素。结论:失眠主诉就诊的患者中,对年龄大、鼾声事件多者要警惕其合并OSA的可能。Objectives:To compare the clinical characteristics of insomnia and insomnia comorbid obstructive sleep apnea(OS A),and to analyze the risk factors of OSA in patients with insomnia.Methods:Medical charts of 455 hospitalized patients with insomnia as chief complaint were reviewed.Patients with apnea hypopnea index(AHI)≥5 times/h were divided into insomnia with OSA group(n=111),and those with AHI<5 times/h were divided into insomnia group(n=344).Demographic characteristics,Hamilton anxiety and depression scores,medication,sex hormone levels and polysomnographic results were compared between the two groups.Logistic regression was used to analyze the risk factors of OSA comorbid with insomnia.Results:Compared with the insomnia group,insomnia with OSA group had older age,higher proportion of male,higher level of follicle stimulating hormone,lower levels of prolactin,estradiol and progesterone,longer latency of N3,higher proportion of N1,lower proportion of N3,shorter total sleep time,lower sleep efficiency,lower lowest-oxygen-saturation,higher periodic leg movement index,more snoring events,higher arousal index(P<0.05).Logistic regression analysis showed that older age(OR=1.03-1.08)and more snoring events(OR=1.01)were risk factors of OSA in insomnia patients.Conclusions:It suggests that among the patients with insomnia,those with older age and more snoring events should be aware of the possibility of OSA.

关 键 词：阻塞性睡眠呼吸暂停 失眠 多导睡眠图 性激素 

分 类 号：R338.63[医药卫生—人体生理学] R563.8[医药卫生—基础医学]