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首页> 外文期刊>Sleep & breathing =: Schlaf & Atmung >Are the adverse effects of body position in patients with obstructive sleep apnea dependent on sleep stage?
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Are the adverse effects of body position in patients with obstructive sleep apnea dependent on sleep stage?

机译：阻塞性睡眠呼吸暂停患者的体位不良影响是否取决于睡眠阶段？

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PURPOSE: The purpose of the study was to determine if the adverse effect of body position on obstructive sleep apnea (OSA) is worsened during rapid eye movement (REM) sleep and if patients with OSA decrease the time spent supine during REM sleep. METHODS: Overnight polysomnography from 80 sequential patients referred to Buffalo VA Sleep Lab for suspected OSA were analyzed with 20 patients in each of the following groups: normal with apnea-hypopnea indices (AHI) <5/h, mild (AHI, 5-< 15/h), moderate (AHI, 15-<30/h), and severe (AHI, >30/h). We used extended Cox models with the Anderson-Gill modification for multiple events with two time varying covariates: sleep stage and body position. Generalized estimating equations with logit link were used to take into account correlated data within each patient for the relation between sleep stage and body position. RESULTS: The hazard ratios for events in REM vs non-REM sleep was significant for the normal, mild, and moderate groups only: 1.71 (95% CI 1.4-2.08), 1.45 (95% CI 1.22-1.73), 1.28 (95% CI 1.1-1.5), respectively. The hazard ratio for events in the supine vs non-supine position was significant for the mild and moderate groups only: 1.25 (95% CI 1.02-1.52) and 1.24 (95% CI 1.04-1.47), respectively. The addition of an interaction effect between sleep stage and body position was not statistically significant for any group. The odds ratios of sleeping in supine position for REM vs non-REM sleep were 0.47 (95% CI 0.27-0.82) for moderate OSA group and 0.54 (95% CI 0.3-0.95) for severe OSA. CONCLUSION: In summary, we found significant effects of both sleep stage and body position in mild and moderate but not severe OSA. Patients with moderate and severe OSA were less likely to spend time in the supine position during REM compared with non-rapid eye movement sleep.
机译：目的：该研究的目的是确定快速眼动（REM）睡眠期间身体姿势对阻塞性睡眠呼吸暂停（OSA）的不良影响是否恶化，以及OSA患者是否减少了REM睡眠期间仰卧的时间。方法：对以下各组中的20例患者进行了分析，其中包括80例转诊至Buffalo VA睡眠实验室的连续患者的疑似OSA的夜间多导睡眠图：呼吸暂停低通气指数（AHI）<5 / h，轻度（AHI，5- < 15 / h），中度（AHI，15- <30 / h）和重度（AHI，> 30 / h）。对于具有两个时变协变量的多个事件，我们将扩展的Cox模型与Anderson-Gill修改一起使用：睡眠阶段和身体位置。使用具有logit链接的广义估计方程来考虑每个患者内有关睡眠阶段与身体位置之间关系的相关数据。结果：仅正常，轻度和中度组，REM和非REM睡眠事件的危险比才有意义：1.71（95％CI 1.4-2.08），1.45（95％CI 1.22-1.73），1.28（95） ％CI 1.1-1.5）。仅在轻度和中度组中，仰卧位和非仰卧位事件的危险比才有意义：分别为1.25（95％CI 1.02-1.52）和1.24（95％CI 1.04-1.47）。在任何阶段，睡眠阶段和身体位置之间的相互作用都没有统计学意义。中度OSA组的REM与非REM睡眠在仰卧位睡觉的几率是0.47（95％CI 0.27-0.82），而重度OSA是0.54（95％CI 0.3-0.95）。结论：总的来说，我们发现轻度和中度而非重度OSA对睡眠阶段和身体位置都有显着影响。与非快速眼动睡眠相比，患有中度和重度OSA的患者在REM期间仰卧的时间更少。

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