睡眠微觉醒时序特征而非AHI指数对轻度OSA日间嗜睡的预测价值
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聂佳磊
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江苏海洋大学，江苏连云港，222005
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摘要： 目的?本研究旨在探讨睡眠微觉醒时序特征对轻度阻塞性睡眠呼吸暂停（OSA）患者日间嗜睡的预测价值，并对比传统?AHI?及血氧参数的评估效能。 方法?回顾性纳入?186?例轻度?OSA?患者，根据?Epworth?嗜睡量表分为嗜睡组与非嗜睡组，提取微觉醒平均间隔、簇发频率、时序不均匀系数及非呼吸相关微觉醒负荷等时序指标，通过统计学方法对比各组指标差异并分析预测价值。 结果?两组患者?AHI、血氧参数无显著差异，嗜睡组微觉醒时序紊乱特征明显；微觉醒时序指标为日间嗜睡的独立预测因素，而?AHI?无独立预测价值，且微觉醒时序联合指标的预测效能显著优于?AHI。 结论?相较于传统?AHI?评估体系，睡眠微觉醒时序特征可更精准反映轻度?OSA?患者睡眠结构损伤与日间功能损害，可为轻度?OSA?精细化临床评估提供新型参考依据。
关健词：阻塞性睡眠呼吸暂停；轻度；睡眠微觉醒；时序特征；日间嗜睡；呼吸暂停低通气指数 |
Predictive value of sleep micro-arousal temporalcharacteristics ratherthan AHI for daytime sleepiness in mild OSA patients
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Jialei Nie
Jiangsu Ocean University, Lianyungang Jiangsu 222005, China
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Abstract：Objective This study aimed to investigate the predictive value of temporal features of sleep micro-arousals for exces-sive daytime sleepiness in patients with mild obstructive sleep apnea (OSA) and to compare their predictive efficacy with traditionalAHI and oxygen desaturation parameters. Methods A total of 186 patients with mild OSA were retrospectively enrolled and dividedinto sleepy and non-sleepy groups based on the Epworth Sleepiness Scale. Temporal indicators including mean micro-arousal inter-val, burst frequency, temporal irregularity coefficient, and non-respiratory-related micro-arousal burden were extracted. Statisticalmethods were used to compare differences between groups and to evaluate predictive value. Results No significant differences werefound in AHI or oxygen parameters between the two groups, whereas the sleepy group exhibited significant temporal disorganizationof micro-arousals. Temporal micro-arousal indicators were independent predictors of daytime sleepiness, while AHI was not. More-over, the combined temporal indicators demonstrated significantly better predictive performance than AHI alone. Conclusion Com-pared with the conventional AHI-based evaluation system, temporal features of sleep micro-arousals more accurately reflect sleeparchitecture disruption and daytime functional impairment in mild OSA, providing a new reference for refined clinical assessment of
this population.
Keywords : obstructive sleep apnea; mild; sleep micro-arousal; temporal characteristics; daytime sleepiness; apnea–hypopnea index
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