体重指数对阻塞性睡眠呼吸暂停低通气综合征患者睡眠特征及夜间低氧血症的影响OA

OBJECTIVE To explore the differences in sleep characteristics among obstructive sleep apnea hypopnea syndrome(OSAHS)patients with different body mass index(BMI)levels and to analyze the correlation between sleep structure parameters and nocturnal hypoxemia.METHODS A total of 140 patients with OSAHS who were treated at Xingtan Branch of the Eighth Affiliated Hospital of Southern Medical University from May 2021 to May 2024 were selected as the research subjects.The patients were divided into normal,overweight,and obese groups based on their BMI levels.Those with a cumulative time of nocturnal arterial oxygen saturation below 90%accounting for≥30%of total sleep time were defined as the nocturnal hypoxemia group,while the rest were classified as the non-nocturnal hypoxemia group.Multiple linear regression was used to analyze the association between BMI levels and sleep structure parameters;the mediating effect of sleep characteristics in the relationship between BMI and nocturnal hypoxemia was analyzed;the differences in nocturnal hypoxemia among patients with different sleep characteristics at different BMI levels were compared;and the predictive efficacy of sleep characteristic parameters for nocturnal hypoxemia in patients with different BMI levels at different apnea-hypopnea index(AHI)cutoff values was analyzed using the receiver operating characteristic curve(ROC).RESULTS The total sleep time(TST),sleep efficiency(SE),rapid eye movement(REM)period proportion,and lowest oxygen saturation(LSaO2)were all lower in the overweight and obese groups than in the normal group.The multiple linear regression results showed that BMI levels were significantly negatively correlated with TST,SE,REM,and LSaO2(P<0.05).Logistic regression analysis results indicated that BMI were independent risk factors(P<0.05).TST,SE,REM,and LSaO2 all played a mediating role between BMI and nocturnal hypoxemia(P<0.001).The incidence of hypoxemia in the obese group was significantly higher than that in the normal and overweight groups in the subgroups with TST<4.00 h,REM<13.00%,SE<70.00%and LSaO2<65.00%.The ROC results showed that AHI≥15 times/h and≥30 times/h had a high value in predicting nocturnal hypoxemia.CONCLUSION BMI levels significantly affect the sleep characteristics and nocturnal hypoxemia of OSAHS patients.As BMI increases,TST,SE,REM period proportion,and LSaO2 show a downward trend,and the incidence of nocturnal hypoxemia increases accordingly.