Article record

心房颤动患者体位性阻塞性睡眠呼吸暂停与日间过度嗜睡之间的关系

Relationship between Positional Obstructive Sleep Apnea and Excessive Daytime Sleepiness in Patients with Atrial Fibrillation.

临床研究咽喉科IF 2Q3

文献信息

PMID	42807711
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Xiaoyue Liu 查看其他 9 位作者 Patrick Stafford；Kenneth Bilchick；Sula Mazimba；Jeongok Logan；Yeilim Cho；Paras Patel；McCall Walker；William Healy；Younghoon Kwon
作者单位	New York University Rory Meyers College of Nursing, 433 First Avenue, New York, NY 10010, USA. 查看其他 8 条单位信息 University of Virginia School of Medicine, 1415 Jefferson Park Avenue, Charlottesville, VA 22903, USA.；Advent Health, 2415 North Orange Avenue, Suite 700, Orlando, FL 32804, University of Virginia School of Medicine, 1415 Jefferson Park Avenue, Charlottesville, VA 22903, USA.；University of Virginia School of Nursing, 225 Jeannette Lancaster Way, Charlottesville, VA 22903, USA.；Veteran's Affairs Puget Sound Health Care System, Seattle VA Medical Center, 1660 South Columbian Way, Seattle, WA 98108, USA.；Prisma Health, 8 Med Park 100, 8 Richland Medical Park Drive, Suite 100, Columbia, SC 29203, USA.；Cardiovascular Institute of the South, 225 Dunn Street, Houma, LA 70360, USA.；Augusta University Medical College of Georgia, 1120 15th Street, Augusta, GA 30912, USA.；University of Washington Department of Medicine, 959 NE Pacific Street, Seattle, WA 98195, USA.
期刊	Sleep and biological rhythms
SCI 分区	Q3
IF	2
研究类型	临床研究 · 临床
所属专科	咽喉科

中文摘要

目的： 阻塞性睡眠呼吸暂停（OSA）在心房颤动（AF）患者中高度普遍。既往研究提示，日间过度嗜睡（EDS）作为OSA的常见症状，在AF患者中表现较轻。本研究聚焦于OSA的一种亚型——体位性OSA（POSA），并分别在合并与未合并AF的患者中，以及总体人群中，探讨其与EDS的关联。
方法： 本研究纳入222例有或无AF病史的OSA患者，均接受实验室多导睡眠监测。POSA采用三种标准定义：传统POSA（cPOSA；仰卧位/非仰卧位呼吸暂停低通气指数[AHI]比值≥2）、中等保守POSA（iPOSA；仰卧位/非仰卧位AHI比值≥3）以及专属POSA（ePOSA；仰卧位/非仰卧位AHI比值≥2且非仰卧位AHI<5次/小时）。EDS由Epworth嗜睡量表评分≥11确定。采用logistic回归评估相关性。
结果： 总体上，55.4%的患者存在cPOSA，43.6%报告EDS。对整个队列的分析显示，与无POSA者相比，cPOSA患者（调整后比值比[aOR]：0.51，95%置信区间[CI]：0.26-0.98）或iPOSA患者（aOR：0.37，95% CI：0.18-0.74）发生EDS的比值更低。在AF患者中，cPOSA与EDS发生比值降低相关（aOR：0.32，95% CI：0.11-0.90）。在无AF患者中，iPOSA与EDS发生比值降低相关（aOR：0.28，95% CI：0.10-0.75）。
结论： POSA与EDS之间的关联因POSA定义和AF状态而异。研究结果提示，在AF患者中，EDS的表现因cPOSA状态而不同。

英文摘要

PURPOSE: Obstructive sleep apnea (OSA) is highly prevalent in patients with atrial fibrillation (AF). Prior studies suggest that excessive daytime sleepiness (EDS), a common symptom of OSA, is less pronounced in patients with AF. This study focused on a subtype of OSA, positional OSA (POSA), and examined its association with EDS overall and separately in patients with and without AF.
METHODS: This study included 222 OSA patients with and without AF history who underwent in-lab polysomnography. POSA was defined using three criteria: conventional POSA (cPOSA; supine/non-supine apnea-hypopnea index [AHI] ratio ≥ 2), intermediately conservative POSA (iPOSA; supine/non-supine AHI ratio ≥ 3), and exclusive POSA (ePOSA; supine/non-supine AHI ratio ≥ 2 and non-supine AHI < 5 events/h). EDS was determined by an Epworth Sleepiness Scale score ≥ 11. Logistic regression was performed to assess the associations.
RESULTS: Overall, 55.4% of patients had cPOSA, and 43.6% reported EDS. Analysis of the entire cohort showed that patients with cPOSA (adjusted odds ratio [aOR]: 0.51, 95% confidence interval [CI]: 0.26-0.98) or iPOSA (aOR: 0.37, 95% CI: 0.18-0.74) had lower odds of EDS than their non-POSA counterparts. Among patients with AF, cPOSA was associated with lower odds of EDS (aOR: 0.32, 95% CI: 0.11-0.90). Among patients without AF, iPOSA was associated with lower odds of EDS (aOR: 0.28, 95% CI: 0.10-0.75).
CONCLUSION: The association between POSA and EDS varied by POSA definitions and AF status. The findings suggest that EDS manifests differently by cPOSA status in patients with AF.