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Impacto da fase REM no índice de apneia-hipopneia
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Abstract(s)
A Síndrome da Apneia/Hipopneia Obstrutiva do Sono (SAHOS) carateriza-se por episódios de obstrução parcial ou total das vias aéreas durante o sono, e em REM a tendência é maior. Contudo subsistem dúvidas quanto ao Índice Apneia-Hipopneia (IAH) nas duas fases do sono. É também em decúbito dorsal que a tendência para a via aérea colapsar é maior, mas estudos alegam que a fase REM está mais associada ao dormir em decúbito lateral, sugerindo que a posição corporal é um possível fator de confusão.
Deste modo comparou-se o IAH em REM e NREM, e relacionou-se o IAH com a posição corporal. Avaliou-se o índice de dessaturação de oxigénio (IDO) nas duas fases, e foi analisado o IAH em REM e NREM com relação á faixa etária. Para tal analisaram-se 23 polissonografias realizadas no Hospital das Forças Armadas entre Dezembro de 2013 e Março de 2014.
Constatou-se que o IAH é mais elevado em NREM (p= 0,003), e confirmou-se que o IAH é superior em decúbito dorsal (p= 0,073). O IDO foi mais elevado em REM (p= 0,627). Contudo, a saturação mínima de O2 foi mais baixa em NREM. Quando se examinou o IAH por idades, constatou-se que tanto nos indivíduos com menos de 60 anos, ou mais, o IAH é maior em NREM.
Concluiu-se que apesar das características do REM poderem provocar agravamento da SAHOS, o presente estudo concluiu que o IAH é superior em NREM. Contudo foi em REM que se observou aumento do IDO. O IAH foi também superior na posição de decúbito dorsal, confirmando a sua influência na SAHOS.
The Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) is characterized by episodes of partial or complete obstruction of the upper airways during sleep and in REM the tendency increases. However doubts remain over the Apnea-Hypopnea Index (AHI) in the two stages of sleep. It is also in dorsal decubitus that the tendency for upper airway collapse increases, but studies suggests that the REM stage is largely associated with sleeping in the lateral decubitus position, therefore suggesting that this body position is a possible factor of confusion. Therefore it was made a comparison of AHI between REM and NREM stages and a relation of AHI and the body position. The oxygen desaturation index (ODI) was evaluated in the two stages and the AHI was analysed between REM and NREM in relation with group age. For that objective, 23 polysomnographies were performed at the Armed Forces Hospital between December 2013 and March 2014. It was ascertained that the AHI was higher in NREM (p= 0,003) and it was confirmed that AHI was higher in dorsal decubitus (p= 0,073). The ODI was higher in REM (p =0, 627), however the minimal saturation of O2 was lower in NREM. When the AHI was examined by age, it ascertained that the AHI was higher in NREM both in individuals with less than 60 years of age or higher. Therefore it was concluded that, despite the characteristics of REM possibly causing an aggravation of OSAHS, the present study concluded that AHI was superior in NREM. However it was in REM that the rise of ODI was observed. The AHI was also superior in the dorsal decubitus position, therefore confirming its influence in OSAHS.
The Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) is characterized by episodes of partial or complete obstruction of the upper airways during sleep and in REM the tendency increases. However doubts remain over the Apnea-Hypopnea Index (AHI) in the two stages of sleep. It is also in dorsal decubitus that the tendency for upper airway collapse increases, but studies suggests that the REM stage is largely associated with sleeping in the lateral decubitus position, therefore suggesting that this body position is a possible factor of confusion. Therefore it was made a comparison of AHI between REM and NREM stages and a relation of AHI and the body position. The oxygen desaturation index (ODI) was evaluated in the two stages and the AHI was analysed between REM and NREM in relation with group age. For that objective, 23 polysomnographies were performed at the Armed Forces Hospital between December 2013 and March 2014. It was ascertained that the AHI was higher in NREM (p= 0,003) and it was confirmed that AHI was higher in dorsal decubitus (p= 0,073). The ODI was higher in REM (p =0, 627), however the minimal saturation of O2 was lower in NREM. When the AHI was examined by age, it ascertained that the AHI was higher in NREM both in individuals with less than 60 years of age or higher. Therefore it was concluded that, despite the characteristics of REM possibly causing an aggravation of OSAHS, the present study concluded that AHI was superior in NREM. However it was in REM that the rise of ODI was observed. The AHI was also superior in the dorsal decubitus position, therefore confirming its influence in OSAHS.
Description
Keywords
SAHOS Índice de Apneia / Hipopneia REM NREM OSAHS Apnea / Hypopnea Index