Abstract
Background Obesity is a recognized risk factor for the development of obstructive sleep apnea hypopnea syndrome (OSAHS).Changing sleep position as a treatment for OSAHS has been widely recommended.However,few researches exist in China for the effect of changing sleep position on OSAHS patients with different degrees of obesity.Objective To investigate the effect of sleep position and obesity degrees on OSAHS,and the relationship between positional OSAHS and anthropometric parameters of obesity.Methods We conducted a retrospective study on 678 patients with OSAHS determined by overnight polysomnography (PSG) in West China Hospital,Sichuan University,from January 2015 to June 2016.We obtained and analyzed the baseline and PSG characteristics of the patients,and calculated the postural dependence index.The patients were divided into 3 groups:normal weight group (n =139),overweight group (n =315) and obese group (n =224) according to body mass index (BMI).We compared the anthropometric parameters and PSG characteristics between the positional OSAHS group (n =288) and the non-positional OSAHS group (n =390) divided by the postural dependence index.Influencing factors for positional OSAHS were investigated.Results There were significant differences in score of Epworth Sleepiness Scale (ESS),arousal index,respiratory effort related arousals (RERA) index,apnea-hypopnea index (AHI),SaO2 ＜ 90％ time / total sleep time (TST),mean SaO2 (MSaO2),lowest SaO2 (LSaO2),non-supine AHI,supine AHI and positional dependency index among normal weight group,overweight group and obese group (P ＜ 0.05).The male ratio,BMI,waist circunfference,hip circumference,waist-to-hip ratio,score of ESS,arousal index,RERA index,AHI and SaO2 ＜ 90％ time / TST of positional OSAHS group were significantly lower than those of non-positional OSAHS group (P ＜ 0.05).Furthermore,positional OSAHS group had higher MSaO2 and LSaO2 (P ＜ 0.05).Results of Spearman correlation analysis showed that positional dependency was negatively correlated with BMI,waist circumference,hip circunfference and waist to hip ratio (rs =-0.295,-0.289,-0.219,-0.236,P ＜0.001,respectively).Multivariate Logistic regression analysis found that positional OSAHS had a regression relationship with gender [OR =0.620,95％ CI (0.392,0.979),P =0.040] and BMI [OR=0.879,95％CI (0.802,0.943),P=0.001].Conclusion The severity of OSAHS is significantly correlated with the degree of obesity,while BMI shows an inverse relationship with positional dependency.Gender and BMI are independent factors for postural OSAHS.The higher the BMI,the less effects that changing sleep position would have on respiratory events.Thus,positional therapy alone may not improve the conditions of such patients.More active treatments should be considered as soon as possible.关键词
睡眠呼吸暂停,阻塞性/人体质量指数/睡眠/肥胖症Key words
Sleep apnea, obstructive/Body mass index/Sleep/Obesity分类
医药卫生
