阻塞性睡眠呼吸暂停绝经后女性日间过度嗜睡的多导睡眠图特征

文献信息

中文摘要

引言： 阻塞性睡眠呼吸暂停（OSA）中的日间过度嗜睡（EDS）与不良的心血管代谢及安全结局相关，但已有的相关因素可能不适用于绝经后女性。关于该人群中EDS的多导睡眠图决定因素的数据仍然有限。我们研究了多导睡眠图参数与EDS之间的关联，并确定了可能有助于判别绝经后OSA女性EDS的关键参数。
方法： 在这项回顾性横断面研究中，216例经1级多导睡眠图（PSG）确诊的绝经后OSA女性，根据Epworth嗜睡量表（ESS 10；n = 110）被归类为患有EDS，或根据ESS < 10（n = 106）被归类为非EDS。比较了多导睡眠图变量，并使用多变量logistic回归构建多导睡眠图多变量模型。
结果： 患有EDS的女性比无EDS者更年轻，且BMI和颈围更高（p < 0.05）。较高的呼吸紊乱指数（RDI）值（总、仰卧位、REM和NREM）以及较低的最低血氧饱和度与EDS独立相关。一个四变量模型（RDI、REM RDI、平均和最低血氧饱和度）显示出中等判别能力（AUROC 0.693）。
讨论： EDS在呼吸负荷更大和夜间低氧血症更严重的女性中更为常见。未来使用多维数据的研究可能会提高模型性能和临床适用性。

英文摘要

INTRODUCTION: Excessive daytime sleepiness (EDS) in obstructive sleep apnea (OSA) is linked to adverse cardiometabolic and safety outcomes, but established correlates may not apply to postmenopausal women. Data on polysomnographic determinants of EDS in this group remain limited. We examined associations between polysomnographic parameters and EDS and identified key parameters that may help discriminate EDS in postmenopausal women with OSA.
METHODS: In this retrospective cross-sectional study, 216 postmenopausal women with OSA, confirmed by Level 1 polysomnography (PSG), were classified as having EDS based on the Epworth Sleepiness Scale (ESS 10; n = 110) or as non-EDS (ESS < 10; n = 106). Polysomnographic variables were compared, and multivariable logistic regression was used to build a polysomnographic multivariable model.
RESULTS: Women with EDS were younger and had higher BMI and neck circumference than those without EDS (p < 0.05). Higher respiratory disturbance index (RDI) values (total, supine, REM, and NREM) and lower minimum oxygen saturation were independently associated with EDS. A four-variable model (RDI, REM RDI, mean, and minimum oxygen saturation) showed moderate discrimination (AUROC 0.693).
DISCUSSION: EDS was more frequent among women with greater respiratory burden and worse nocturnal hypoxemia. Future studies using multidimensional data may improve model performance and clinical applicability.