手术治疗阻塞性睡眠呼吸暂停低通气综合征对睡眠结构的影响OA

OBJECTIVE To investigate the impact of surgical treatment on sleep architecture in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS A total of 75 patients diagnosed with OSAHS who underwent surgical treatment in the Department of Otolaryngology,the Fifth Affiliated Hospital of Zhengzhou University from February 2022 to February 2024 were selected.Preoperative and six-month postoperative standard polysomnography were performed.The Epworth Sleepiness Scale(ESS)and the Pittsburgh Sleep Quality Index(PSQI)were used to evaluate the patient's level of sleepiness and sleep quality,respectively.Changes in sleep apnea parameters and indicators related to sleep architecture before and after surgery were analyzed to investigate the impact of surgical treatment for OSAHS on sleep architecture.RESULTS Among the 75 cases,20 were mild OSAHS,25 were moderate,and 30 were severe.After treatment,the apnea-hypopnea index(AHI)significantly decreased from(27.0±14.1)times/hour preoperatively to(11.6±7.7)times/hour postoperatively,while the lowest oxygen saturation significantly improved from(74.0±6.3)%preoperatively to(82.7±5.7)%postoperatively,with statistically significant differences(t=15.358 and 14.406,respectively,both P<0.01).Before treatment,the ESS and PSQI scores in the mild,moderate,and severe groups gradually increased,being 8.3±2.3,11.0±3.6,13.5±4.7 and 5.6±2.1,7.5±2.9,9.1±3.2,respectively,with all differences being statistically significant(F=10.582 and 9.383,respectively,both P<0.05).The proportion of N1 stage sleep time gradually increased with disease severity:(15.4±1.6)%,(17.3±1.9)%,and(19.2±1.8)%,respectively(F=26.253,P<0.01).N2 stage sleep showed an increasing trend:(50.3±1.7)%,(51.9±2.3)%,and(52.3±2.8)%,respectively(F=4.503,P<0.05;no significant change between moderate and severe groups).N3 stage sleep progressively decreased:(15.3±1.4)%,(14.1±1.4)%,and(12.8±2.5)%,(F=10.147,P<0.01).REM sleep also declined:(18.4±1.4)%,(16.6±1.2)%,and(15.6±1.5)%,respectively(F=36.139,P<0.01).Correlation analysis revealed that N1 sleep time was positively correlated with AHI(r=0.563),while N3 and REM sleep times were negatively correlated with AHI(r=-0.387 and-0.570,both P<0.01).The ESS and PSQI scores decreased postoperatively,all patients exhibited a significant reduction in N1 sleep,slight decrease in N2 sleep,marked increase in N3 sleep and REM sleep(all P<0.05).CONCLUSION In OSAHS patients,sleep architecture disturbance worsens with disease severity.Surgical treatment reduces light sleep and increases deep sleep,significantly improving sleep structure in patients with OSAHS.