Uyku Polikliniğine Başvuran Hastaların Bir Yıllık Verilerinin Genel Analizi

Year 2022, Volume: 6 Issue: 1, 98 - 103, 22.04.2022

Mehmet Kabak , İclal Hocanlı

https://doi.org/10.46332/aemj.932563

Abstract

Amaç: Obstrüktif uyku apne sendromu (OUAS) uyku esnasında hipofarenks bölgesinde tam veya kısmi daralmasıyla ve oksijen saturasyonundaki (SO2) düşme sonrasında solunum çabası ve intratorasik basıncın negatifleşmesi ile karakterize bir sendrom-dur. Horlama, gündüz aşırı uykululuk hali ve tanıklı apne OUAS’da en çok gözlenen semptomlardır. Polisomnografi (PSG), OUAS tanısı için kullanılan altın standart bir yöntemdir. Bir yıl boyunca uyku laboratuvarında takip edilen hastalarımızı değerlen-dirmeyi amaçladık.
Araçlar ve Yöntem: Çalışmamıza 1 Ocak 2018-1 Ocak 2019 zaman aralığında uyku laboratuvarımızda yatan 111 hasta dahil edildi. Hastalar 4 gruba ayrılarak demografik ve klinik bulguları karşılaştırıldı.
Bulgular: Hastaların yaş ortalaması 46.55±11.18 yıl idi. Hipertansiyon (HT) görülme sıklığı açısından ağır OUAS grubunda, diğer gruplara kıyasla anlamlı farklılık mevcuttu (p=0.025). Vücut kitle indeksi (VKİ) ağır OUAS grubunda, diğer gruplara göre istatik-sel olarak daha yüksek bulundu (p<0.001). Ayrıca ağır OUAS grubundaki hastalarda hem rapid eye movement (REM) uyku süresi hemde SO2 düzeyi diğer gruptaki hastalara göre istatiksel olarak anlamlı düşük saptandı (p=0.034, p<0.001).
Sonuç: Hastalarımızın çoğu, VKİ >30kg/m2 olan olgularda ağır OUAS olarak saptanmıştır. Uyku laboratuvarları ve polisomnog-rafi, bu hastalığın tanısında önemli rol oynamaktadır. Özellikle Obezite ve HT tanılı olguların OUAS açısından sorgulanması gerekmektedir.

Keywords

apne-hippne indeksi, komorbidite, polisomnografi, uyku

Thanks

Mardin uyku laboratuvarında çalışan tüm personellere teşekkür ederiz.

General Analysis of One-Year Data of Patients Applying to Sleep Polyclinic

Abstract

Purpose: Obstructive sleep apnea syndrome (OSAS) is a syndrome characterized by complete or partial constriction of the hy-popharynx region during sleep and negative respiration effort and intrathoracic pressure after a decrease in oxygen saturation (SO2). Snoring, witnessed apnea, and excessive daytime sleepiness are the most common symptoms in OSAS. Polysomnography (PSG) is the gold standard method used for the diagnosis of OSAS. We purposed to evaluate our patients who were followed up in the sleep laboratory for a year.
Materials and Methods: 111 patients hospitalized in our sleep laboratory between January 1, 2018 and January 1, 2019 were included in our study. Patients were divided into 4 groups, and their demographic and clinical findings were compared.
Results: The mean age of the patients was 46.55±11.18 years. There was a significant difference in the incidence of hypertension (HT) in the severe OSAS group compared to the other groups. There was a significant difference in body mass index (BMI) in the severe OSAS group compared to the other groups. In addition, both rapid eye movement (REM), sleep time, and SO2 levels were found to be statistically significantly lower in the patients in the severe OSAS group compared to the patients in the other group.
Conclusion: Most of our patients were found to have severe OSAS in cases with a BMI> 30kg / m2. Sleep laboratories and poly-somnography play an important role in the diagnosis of this disease. In particular, patients with a diagnosis of obesity and HT should be questioned in terms of OSAS.

Keywords

apnea-hypopnea index, comorbidity, polysomnogaphy, sleep

References

• 1. Sateia MJ. International classification of sleep disorders third edition: highlights and modifications. Chest. 2014;146(5):1387-1394.
• 2. Kaynak H, Kaynak D. Uykuda solunum bozuklukları. Turkiye Klinikleri J Psychiatry. 2001;2:103-107.
• 3. Güven AÖ, Afşar GÇ, Görgün D. Uyku Labora-tuarımızda Bir Yıllık Deneyimimiz. Haydarpasa Numune Med J. 2013;53(3):154-158.
• 4. Anuntaseree W, Rookkapan K, Kuasirikul S, Thongsuksai P. Snoring and obstructive sleep apnea in Thai school-age children: prevalence and predisposing factors. Pediatr Pulmonol. 2001;32(3):222-227.
• 5. Durán J, Esnaola S, Rubio R, Iztueta A. Obstructive sleep apnea-hypopnea and related clinical features in a population based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med. 2001;163(3 Pt 1):685-689.
• 6. Indications and standards for cardiopulmonary sleep studies. American Thoracic Society. Medi-cal Section of the American Lung Association. Am Rev Respir Dis. 1989;139(2):559-568.
• 7. Malow BA. Approach to the patient with disorde-red sleep. Kryger MH, Roth T, Dement WC, Ed. Principles and Practice of Sleep Medicine. 4th ED. Philadelphia, WB Saunders;2005:589-593.
• 8. American Academy of Sleep Medicine. AASM style guide for sleep medicine terminology. Up-dated November 2015. Darien, IL: American Academy of Sleep medicine, 2016.
• 9. Kryger MH, Roth T, Dement WC. Pediatric Pulmonology. Principles and Practice of Sleep Medicine. 3th Ed. Philadelphia: WB Saunders Company; 2000:336.
• 10. Schwab RJ, Goldberg A, Pack A. Sleep apnea sydromes A. Fishman Editor. Fishman’s Pulmo-nary Disease and Disorders. Newyork: Mc Graw Hill Book; 1998:1617-1637.
• 11. Collop NA, Adkins D, Phillips BA. Gender differences in sleep and sleep-disordered breathing. Clin Chest Med. 2004;25(2):257-268.
• 12. Köktürk O, Tatlıcıoğlu T, Kemaloğlu Y, Fırat H, Cetin N. Habituel horlaması olan olgularda obstruktif sleep apne sendromu prevalansı. Tuberk Toraks. 1997;45:7-11.
• 13. Bixler EO, Vgontzas AN, Lin HM, et al. Preva-lence of sleep-disorderedbreathing in women: ef-fects of gender. Am J Respi Crit Care Med. 2001;163(3 Pt 1):608-613.
• 14. Tishler PV, Larkin EK, Schluchter MD, Redline S. Incidence of sleep-disordered breathing in an urban adult population: there lative importance of risk factors in the development of sleep-disordered breathing. JAMA. 2003;289(17):2230-2237.
• 15. Saraç S, Afşar G, Oruç Ö, Kırbaş G, Görgüner AM. Obstrüktif Uyku Apne Sendromlu Hastalarda Ek hastalıklar ile Obezite İlişkisi. Van Med J. 2015:22(4): 246-251.
• 16. Dacal Quintas R, Tumbeiro Novoa M, Alves Pérez MT, et al. Obstructive sleep apnea in normal weight patients: characteristics and comparison with overweight and obese patients. Arch Bronconeumol. 2013;49(12):513-517.
• 17. Floras JS. Hypertension and Sleep Apnea. Can J Cardiol. 2015;31(7):889-897.
• 18. Karakoç Ö, Akçam T, Gerek M, Birkent H. Obstrüktif uyku apnesi ve kronik hastalıklar. KBB Forum. 2008;7(1):15-20.
• 19. Fletcher EC, DeBehnke RD, Lovoi MS, Gorin AB. Undiagnosed slee apnea in patients with essential hypertension. Ann Intern Med. 1985;103(2):190-195.
• 20. Bendtson I, Gade J, Theilgaard A, Binder C. Cognitive function in type 1 (insulin-dependent) diabetic patients after nocturnal hypoglycaemia. Diabetologia. 1992;35(9):898-903.
• 21. Demir S. Obstrüktif Uyku Apne Sendromlu Hastalarda Oksijen Desatürasyonu ve Beck Depresyon İndeksi İlişkisi. J Turk Sleep Med. 2016;3:6-9.
• 22. Arita A, Sasanabe R, Hasegawa R, et al. Risk factors for automobile accidents caused by falling asleep while driving in obstructive sleep apnea syndrome. Sleep Breath. 2015;19(4):1229-1234.
• 23. Vgontzas AN, Fernandez-Mendoza J, Miksiewicz T, et al. Unveiling the longitudinal association between short sleep duration and the incidence of obesity: the Penn State Cohort. Int J Obes (Lond). 2014;38(6):825-832.
• 24. Xie J, Yu W, Wan Z, Han F, Wang Q, Chen R. Correlation Analysis between Obstructive Sleep Apnea Syndrome (OSAS) and Heart Rate Varia-bility. Iran J Public Health. 2017;46(11):1502-1511.
• 25. Silva L, Cunha D, Lopes J, et al. Comorbidities and sleep apnoea severity. A study in a cohort of Portuguese patients. Rev Neurol. 2016;62(10):433-438.
• 26. Haddad RM, AlSureehein SK, Alsamen GA, Alz-boon M, Hazeem AA. Evaluation Of Epworth Sleepiness Scale As A Screening Method For Obstructive Sleep Apnea Syndrome (Osas). Middle East J Intern Med. 2015;8(5):3-6.
• 27. Hornstrup BG, Gjoerup PH, Wessels J, Lauridsen TG, Pedersen EB, Bech JN. Nocturnal Blood PressureDecrease İn Patients With Chronic Kidney Disease And In Healthy Controls Significance Of Obstructive Sleep Apnea And Renal Function. Int J Nephrol Renovasc Dis. 2018;11:279-290.
• 28. American Academy of Sleep Medicine. ICSD-2: The International Classification of Sleep Disorders. Diagnostic and Coding Manual. 2th Ed. Westchester: AASM; 2005.29. Ayık SO, Akhan G, Peker S. Obstruktif Uyku Apne Sendromlu (OSAS) Olgularda Obezite Sık-lığı ve Ek Hastalıklar. Tur Toraks Der. 2011;12(3):105-110.
• 30. Alaçam Z, Pekcan S, Akdağ B, Şenol H. Obstrüktif Uyku Apne Sendromu Tanılı Hastalarda; Hemogram Parametreleri ile Gece Desatürasyonu İlişkisi. J Turk Sleep Med. 2018;5:62-66.
• 31. Iber C, Ancoli-Israel S, Chesson A, Quan SF. The AASM Manual for the Scoring of Sleep and Associated Events. Rules, Terminology and Technical Specifications. Westchester: AASM; 2007.