ABSTRACT
Objective To investigate the efficacy of the hospital intensive treatment by auto-CPAP on elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to analyse the possible factors related to the effectiveness.Methods Subjects were selected from elderly OSAHS patients over 60 years old.The eligible subjects were divided into intensive treatment group and non-intensive treatment group (non-ITG).Patients in intensive treatment group were intensively treated using auto-CPAP for 3 consecutive days,assisted with targeted health education and guidance,and making proper adjustments to parameters of the auto-CPAP according to treatment outcomes at the previous day.But those in non-intensive treatment group were just treated with auto-CPAP for only 1 day,supplemented by regular health education and guidance.The apnea-hypopnea index (AHI),minimum oxygen saturation (SaO2min),mean oxygen saturation (SaO2mean) and the time spent at SaO2 lower than 90％ (tSaO2＜90％),the occurrence of clinical symptoms and adverse effect,Epworth sleepiness scale(ESS) were compared between both groups.The correlation analyses were also conducted.Results ESS (3.58±3.76 vs.6.84 ± 3.22),AHI [(7.85±6.53) time/h vs.(10.42±7.27) time/h] and tSaO2＜90％[(5.65±15.43) min vs.(15.26±33.14) min] were lower(t=6.902,2.760,2.765,allP＜0.05),while SaO2mean [(96.57±1.53)％ vs.(94.63±1.38)％] and SaO2min [(88.24±4.43)％ vs.(83.28±5.06)％]were higher(t=-9.870,-7.740,both P＜0.05)in intensive treatment group than in non intensive treatment group.The occurrences of clinical symptoms and adverse effect (except for skin allergy) were decreased in intensive treatment group versus non-ITG (all P＜0.05).The AHI after intensive treatment was decreased in females versus males [(7.85±5.19) times /h vs.(11.27±7.78) times/h,t=2.133,P＜0.05].BMI,age,gender and the state of OSAHS were correlated to AHI,SaO2 mean,SaO2 min and tSao2＜90％ after intensive treatment (all P＜0.05).Conclusions The hospital intensive treatment can improve the clinical results and decrease the occurrences of clinical symptoms and adverse effect for elderly OSAHS patients,and is expected to improve therapy compliance,and its curative efficacy is correlated to BMI,age,gender and state of OSAHS before therapy.
ABSTRACT
Objective To improve the understanding of the characteristics of obstructive sleep apnea-hypopnea syndrome (OSAHS) in the elderly patients, and to improve the diagnosis and treatment level. Methods Monitoring results of polysomnography (PSG) from 110 elderly OSAHS patients were analyzed retrospectively. The general conditions, sleep architecture, apnea and hypopnea events, oxygen reduction as well as possible correlations between various indicators were analyzed using SPSS18.0 statistical software. Results The median rapid eye movement (REM) and non-REM (NREM) sleep time of elderly patients with OSAHS accounted for 2. 17% and 76.73%,respectively. The median arousal index was 45.6 times/h. The longest time of sleep apnea was (51.94±22.06) s, the median of average sleep apnea time was 22.50 s, the longest time of hypopnea was (47.06±12.52) s and the average hypopnca time was (21.50±4.63) s. The median respiratory disturbance index (RDI) of all patients was 21.50, the patients with RDI between 5 and 20 accounted for 46.40%, with RDI between 20 and 40 accounted for 31.80% and with RDI over 40 accounted for 21.8%. The average oxygen saturation accounted for (93.45% ± 2.81%), the lowest oxygen saturation accounted for (76.3%± 10. 5%) and the median oxygen desaturation index was 31.6;times/h. BMI was negatively correlated with lowest oxygen saturation (r=-0. 378, P＜0.01) and average oxygen saturation ( r = - 0. 355, P ＜ 0. 01 ), while was positively correlated with oxygen desaturation index (r=0. 338, P＜0. 01 ). The lowest oxygen saturation was negatively correlated with the longest time of obstructive apnea (r= -0. 47, P＜0. 01 ), the average time of obstructive apnea (r=-0.316, P＜0.01), the longest time of hypopnea (r=-0.293, P＜0.01) and the average time of hypopnea (r=-0. 277, P＜0.01). The median time intervals of oxygen desaturation during supine, left side and right side position were 2.36 min, 11.54 min and 12.45 min,respectively. The median time intervals of oxygen desaturation during left side and right side position were both longer than that of supine position (Z= -6.12 and -7. 10 respectively, both P＜0.01).Conclusions Elderly patients with OSAHS manifest obvious disorder of sleep structural and sleep fragmentation. According to RDI, the majority of the patients are classified as mild to moderate in severity. However, elderly patients with OSAHS are severe regarding to hypoxia relatively. The severity of hypoxia is related with BMI and the lasting time of sleep-disordered breathing events, and hypoxia are less severe when sleeping on left side or on right side.
ABSTRACT
Objective To investigate the possible correlation of the clinical parameters, such as age, obesity, Epworth sleepiness score (ESS), with the severity of snoring and obstructive sleep apnea hypopnea syndrome (OSAHS). Methods One hundred and forty-eight patients with snoring during sleep admitted from May to Jul. 2008 were asked to answer the questions from a questionnaire concerning snoring, daytime sleepiness, and habits such as smoking and drinking, etc. All patients underwent at least a polysomnography (PSG) and the physical examination included height, weight, and body mass index (BMI). Age, BMI, the lowest SaO_2(%), ESS score, the biggest reduction of oxygen (%), a total suspension of time, the average correlation between respiratory disorder index (RDI) applied computing Pearson correlation test. Simple snoring and OSAHS group of mild, moderate and severe inter-group comparison analysis using generalized linear models. Results The prevalence of OSAHS was increased with age, higher in males than in females. A statistically significant correlation between ESS, BMI, the lowest SaO_2 with the RDI was detected. The difference of ESS, the lowest SaO_2 and the BMI was significant between the different serious patients (P<0.05). Conclusions OSAHS has a high morbidity rate in outpatients with snoring. Age and obesity are liability factors of OSAHS. BMI, the lowest SaO_2, ESS and RDI have well correlationship, which can be used to assess the pathogenetic condition, even make a primary diagnosis.