Pozisyonel obstrüktif uyku apne sendromlu hastaların klinik ve polisomnografik özellikleri
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Tarih
2012
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info:eu-repo/semantics/openAccess
Özet
Amaç: Obstrüktif uyku apne sendromlu (OUAS) hastalardan, sırt üstü yatış pozisyonunda, yan yatış pozisyonuna göre, apne hipopne indeksi (AHİ) en az iki kat artan veya yan yatış pozisyonunda normalleşen (AHİ5) hastalar yani pozisyonel hastalar ile sırt üstü yatış pozisyonlarında AHİde iki kattan daha az bir artış olan pozisyonel olmayan OUASli hastaların klinik bulgularının, fizik muayene bulgularının ve polisomnografik özelliklerinin karşılaştırılması. Gereç ve Yöntemler: 2006-2008 tarihleri arasında kliniğimize başvuran ve polisomnografi (PSG) yapılarak obstrüktif uyku apne sendromu tanısı alan 500 hastanın tıbbi kayıtları retrospektif olarak incelendi; 230 hasta çalışmaya dahil edildi. PSG bulgularına göre hastalar pozisyonel (PH) ve pozisyonel olmayan (POH) olarak gruplara ayrıldı; iki grubun klinik özellikleri, fizik muayene bulguları ve polisomnografik özellikleri belirlendi ve karşılaştırıldı. Bulgular: İki yüz otuz hastanın 112si (%48,6) PH idi. PHler POHlerden daha genç, vücut kitle indeksleri ve boyun çevreleri daha düşük hastalardı ve daha hafif dereceli OUASye sahiptiler. PHlerin %31inde AHİ yan yatış pozisyonunda 5in altına iniyordu. Epworth uykululuk skalası ile değerlendirilen gündüz aşırı uyku hali PH grubunda daha hafifti. PHlerde yıl boyu süren burun tıkanıklığı şikâyeti ve muayenede konka hipertrofisi sıklığı POHye göre daha fazlaydı. Sonuç: Bu çalışmayla, iki yıllık bir süreyi kapsayan hasta kayıtlarımızdan pozisyonel OUAS tanısı alanların temel özelliklerini, hastalığın pozisyonel olup olmamasına göre gruplandırarak belgelemiş olduk. Pozisyonel hastaların bazı klinik, fizik muayene ve polisomnografik bulgularında POHye göre farklılıklar tespit edildi.
Aim: Positional patients (PP) were patients with obstructive sleep apnea (OSA) whose apnea hypopnea index (AHI) becomes at least twice as high in the supine position as in the lateral position and an AHI that normalizes (AHI<5) in the non-supine position. Non-positional patients (NPP) were characterised by an AHI in the supine position less than twice as high as in the lateral position. In this study we aimed to compare clinical, polysomnographic and physical characteristics of patients with non-positional and positional sleep apnea. Materials and Methods: Medical records of 500 patients diagnosed with OSA syndrome (OSAS) by polysomnography (PSG) in our clinic, between 2006-2008, were retrospectively reviewed, and 230 of these were included in the study. Patients were separated into two groups according to polisomnographic results as PP and NPP. The clinical, polysomnographic and physical characteristics of the two groups were compared. Results: 112 of the 230 patients (48.6%) were classified as PP. These were younger, with lower body mass index and neck circumflex and a milder OSAS as compared to the NPP. AHI in 31% of the PP fell below 5 in the lateral recumbent position. Excessive daytime sleepiness (EDS), as assessed by the Epworth Sleepiness Scale, was lighter in the PP group. Also, frequency of complaint from year-long nasal blockage and frequency of finding turbinate hypertrophy were more common in the PP as compared to the NPP. Conclusion: In this study, basic features of patients diagnosed as positional OSAS over a two-year period were documented by grouping as PP and NPP. Some differences were identified at the physical examination, clinical and polysomnographic features of the positional and non-positional cases.
Aim: Positional patients (PP) were patients with obstructive sleep apnea (OSA) whose apnea hypopnea index (AHI) becomes at least twice as high in the supine position as in the lateral position and an AHI that normalizes (AHI<5) in the non-supine position. Non-positional patients (NPP) were characterised by an AHI in the supine position less than twice as high as in the lateral position. In this study we aimed to compare clinical, polysomnographic and physical characteristics of patients with non-positional and positional sleep apnea. Materials and Methods: Medical records of 500 patients diagnosed with OSA syndrome (OSAS) by polysomnography (PSG) in our clinic, between 2006-2008, were retrospectively reviewed, and 230 of these were included in the study. Patients were separated into two groups according to polisomnographic results as PP and NPP. The clinical, polysomnographic and physical characteristics of the two groups were compared. Results: 112 of the 230 patients (48.6%) were classified as PP. These were younger, with lower body mass index and neck circumflex and a milder OSAS as compared to the NPP. AHI in 31% of the PP fell below 5 in the lateral recumbent position. Excessive daytime sleepiness (EDS), as assessed by the Epworth Sleepiness Scale, was lighter in the PP group. Also, frequency of complaint from year-long nasal blockage and frequency of finding turbinate hypertrophy were more common in the PP as compared to the NPP. Conclusion: In this study, basic features of patients diagnosed as positional OSAS over a two-year period were documented by grouping as PP and NPP. Some differences were identified at the physical examination, clinical and polysomnographic features of the positional and non-positional cases.
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14
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1
