Objective To investigate the prevalence of obstructive sleep apnea hypopnea syndrome ( OSAHS) in patients with idiopathic pulmonary fibrosis ( IPF) and its clinical significance. Methods Sleep quality and breathing disorders were measured by polysomnography and the relationship with lung function was analyzed in 20 IPF patients. Results Thirteen of 20 subjects ( 65% ) had OSAHS as defined by an AHI ≥5 events per hour. Three subjects ( 15% ) had mild OSAHS ( AHI,5 to 20 events per hour) , and 10 subjects ( 50% ) had moderate-to-severe OSAHS ( AHI≥20 events per hour) . The sleep architecture in these patients showed a reduction in sleep efficiency, rapid eye movement ( REM) sleep and slow wave sleep, and a marked sleep fragmentation due to an increased arousal index. The AHI was negatively correlated with FVC% pred ( r =-0.672, P=0.001) and FEV1% pred ( r =-0.659, P=0.002) , and positively correlated with body mass index ( BMI) ( r=0.791, Plt;0.0001) . Conclusions OSAHS is a common comorbidity in IPF. Early treatment of OSAHS may improve quality of life and the prognosis of patients with IPF.
Objective To explore the daytime variables which are predictive to nocturnal hyoxemia among COPD patients unqualified for long-term oxygen therapy ( LTOT) . Methods Forty-eight stable COPD patients with SaO2≥90% were enrolled in this study and regarded as patients unqualified for LTOT. All patients underwent lung function examination during daytime. Their nocturnal oxygen saturation was monitored with overnight pulse oximetry ( OPO) . ResultsDaytime oxygen saturation was positively correlated with nocturnal mean SaO2 ( r =0. 79, P lt;0. 0001) , and negatively correlated with time spend with saturation below 90% ( TB90) ( r = - 0. 75, P lt; 0. 0001) . No significant relationship was found between lung function parameters and nocturnal SaO2 . The patients with daytime oxygen saturation between 90% and 95% were more likely to have lower nocturnal oxygen saturation and longer TB90 ( P lt;0. 05) .Conclusions Daytime oxygen saturation may effectively predict the occurrence of nocturnal hyoxemia in stable COPD patients unqualified for LTOT. To reduce COPD complications and improve prognosis, we suggest a relative indication of LTOT for patients with daytime oxygen saturation between 90% and 95% and with nocturnal hyoxemia.
Objective To investigate the association between types of rapid eye movements during sleep and ICD-10 as a mothod for diagnosing depression. Methods Depression was diagnosed according to ICD-10 and changes of 9 variables of REM sleep in 120 psychiatric outpatients and inpatients by calculating the Kappa values. Results In 120 psychiatric patients, 52 depressive patients were diagnosed by using ICD-10, and 58 patients were diagnosed as depression according to decreased REM sleep latency and increased REM activity, REM intensity, REM density, and increasing amount of REM sleep. Kappa value was 0.73, Plt;0.05, which implied that these two diagnosing ways were significantly consistent. Conclusions Measuremen of REM sleep variable should be investigated further as a supplementary method for diagnosing depression.
目的:了解阻塞性睡眠呼吸暂停综合征患者的心率变异改变。方法:对67例睡眠打鼾患者同步进行24小时动态心电图及多导睡眠图监测。根据PSG检测结果分为OSAS组和单纯鼾症组,比较组间低频峰(LF),高频峰(HF),低频峰与高频峰的比值(LF/HF),正常RR间期平均值及其标准差值(SDNN),正常RR间期差值均方根(rMSSD)。结果:OSAS组中,频域分析指标:LF,HF,均低于单纯鼾症组,LF/HF高于对照组,时域分析指标:SDNN,rMSSD均低于对照组。结论:OSAHS患者心率变异性降低。
目的:了解阻塞性睡眠呼吸暂停综合症(OSAHS)患者夜间心律失常的发生情况、常见类型及相关因素。方法:对67例睡眠打鼾患者同步进行动态心电图及多导睡眠图监测。以呼吸暂停指数及夜间最低氧饱和度将研究对象进行分组,比较分析夜间心律失常发生率及发生类型并进一步分析夜间心律失常的相关因素。结果:OSAS组的夜间心律失常发生率显著高于单纯鼾症患者。随着OSAS加重,呼吸暂停低通气指数逐渐增大,夜间氧饱和度下降越明显,心律失常发生率升高,发生时间延长、恶性程度增加,尤其以缓慢型心律失常的发生率增多。结论:OSAHS患者夜间心律失常的发生率及严重程度与OSAHS严重程度呈正相关,夜间心律失常的诱发与呼吸暂停低通气指数及低氧血症密切相关。应重视夜间心律失常患者合并存在的OSAHS的诊治。
Objective To investigate the differences in clinical characteristics and polysomnographic characteristics between the elderly obstructive sleep apnea-hypopnea syndrome ( OSAHS) patients and the young and middle-aged OSAHS patients. Methods The clinical manifestations and the polysomnographic characteristics of 37 elderly OSAHS patients and 294 young and middle-aged patients were analyzed. The differences in polysomnographic indicators between two groups were compared according to the body mass index.Results The nocturia frequency in the elderly OSAHS patients was higher( P =0. 01) ,however, the othert clinical manifestations between the elderly group and the young and middle-aged group were not different significantly. The elderly group had a lower body mass index ( P =0. 018) , a smaller neck circumference ( P =0. 003) , and a larger chance of diabetes ( P = 0. 001) and hypertension( P lt; 0. 001) .The phase Ⅰ and phase Ⅱ sleep of the elderly group took a longer duration ( P lt; 0. 001) and a larger proportion( P lt;0. 001) . The sleep apnea-hypopnea index between two groups did not show any significant difference( P =0. 082) . The lowest night oxyhemoglobin saturation of the elderly group was higher than that of the young and middle-aged group( P =0. 009) , but such difference disappeared after adjustment by weight ( P =0. 114) . Conclusions The major clinical manifestations of the elderly OSAHS patients are similar to the young and middle-aged patients. The elderly patients are thinner than the young and middle-aged patients, but have more complications and a higher frequency of nocturia. The night oxyhemoglobin saturation is lower in young and middle-aged patients which is associated with higher body mass index.
Obstructive sleep apnea hypopnea syndrome (OSAHS) can affect the growth and development of minors. Although the gold standard for OSAHS diagnosis is an overnight polysomnography, its clinical application is limited due to the high requirements for equipment and environmental conditions. Body shape indicators can reflect the accumulation of fat in specific parts of the body. In recent years, body shape indicators (body mass index, neck circumference, waist circumference, waist to hip ratio, waist to height ratio, neck circumference to height ratio) have been increasingly used in the evaluation of minor OSAHS. This article will review the application of the above body shape indicators in the evaluation of minor OSAHS, aiming to provide a basis for better use of these indicators in the diagnosis and treatment of minor OSAHS.
Polysomnography (PSG) monitoring is an important method for clinical diagnosis of diseases such as insomnia, apnea and so on. In order to solve the problem of time-consuming and energy-consuming sleep stage staging of sleep disorder patients using manual frame-by-frame visual judgment PSG, this study proposed a deep learning algorithm model combining convolutional neural networks (CNN) and bidirectional gate recurrent neural networks (Bi GRU). A dynamic sparse self-attention mechanism was designed to solve the problem that gated recurrent neural networks (GRU) is difficult to obtain accurate vector representation of long-distance information. This study collected 143 overnight PSG data of patients from Shanghai Mental Health Center with sleep disorders, which were combined with 153 overnight PSG data of patients from the open-source dataset, and selected 9 electrophysiological channel signals including 6 electroencephalogram (EEG) signal channels, 2 electrooculogram (EOG) signal channels and a single mandibular electromyogram (EMG) signal channel. These data were used for model training, testing and evaluation. After cross validation, the accuracy was (84.0±2.0)%, and Cohen's kappa value was 0.77±0.50. It showed better performance than the Cohen's kappa value of physician score of 0.75±0.11. The experimental results show that the algorithm model in this paper has a high staging effect in different populations and is widely applicable. It is of great significance to assist clinicians in rapid and large-scale PSG sleep automatic staging.