目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的睡眠结构改变及其与主观日间嗜睡的相关性.方法 收集625例OSAHS患者的病史、Epworth嗜睡评分(ESS)、体格检查和多导睡眠监测(PSG)结果,分析OSAHS患者睡眠结构的改变,及睡眠结构与ESS评分的相关性.结果 625例患者的中位睡眠效率、N1期比例、N2期比例、N3期比例和REM期比例分别为89%、38%、47.7%、1.8%和8.8%.不同严重程度OSAHS患者睡眠效率、N1期、N2期、N3期和REM期比例差异有统计学意义.N1期比例和N3期比例在不同性别间差异有统计学意义,睡眠效率、N2期和REM期比例无显著性别差异.睡眠效率、N1期、N3期、REM期比例在不同年龄段患者差异有统计学意义,N2期比例在不同年龄段差异无统计学意义.所有OSAHS患者中ESS评分与睡眠效率和N1期睡眠比例呈正相关,相关性较差;ESS评分与N2期睡眠比例、N3期睡眠比例和REM睡眠比例呈负相关,相关性较差.结论 OSAHS患者存在显著睡眠结构紊乱,N1期睡眠比例增多,N3期和REM期睡眠比例减少.OSAHS严重程度、性别、年龄对睡眠结构有影响.OSAHS患者的日间嗜睡与睡眠结构存在较弱的相关性.%Objective Excessive daytime sleepiness is a common symptom of patients with OSAHS,which may be associated with the alterations of sleep architecture. To investigate the alterations of sleep architecture and the possible relationship with excessive daytime sleepiness in patients with OSAHS.Methods Clinical history,the Epworth sleepiness scale scores,physical examination and polysomnographical data were colected from625 patients confirmed with OSAHS. Sleep architecture was evaluated and its relationship with the Epworth sleepiness scale scores were analyzed.Results The median sleep efficiency,stage N1,stage N2,stage N3 and rapid eye movement(REM)sleep were89%,38%,47.7%,1.8% and8.8%, respectively. The median sleep efficiency,stage N1,stage N2,stage N3 and REM sleep were different between patients with different severity. Stage N1 and N3 were different between genders,while sleep efficiency,stage N2 and REM sleep had no significant gender differences. The median sleep efficiency,stage N1,stage N3 and REM sleep were different between different age groups,while stage N2 had no significant age differences. Positive and week correlation could be found between ESS scores and sleep efficiency and stage N1 in al patients. Inverse and week correlation could be found between ESS scores and stage N2,stage N3 and REM sleep.Conclusion Sleep architecture is abnormal obviously in OSAHS patients,with increased stage N1 and decreased stage N3 and REM sleep. Sleep architecture can be influenced by gender,age and the severity of disease. Weak correlation exists between ESS scores and sleep architecture.
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