阻塞型睡眠呼吸中止症高風險族群之居家睡眠檢查

Evaluation of Home Sleep Test for Obstructive Sleep Apnea in High-Risk Population

周泰君(Tyron Tai-Chun Chou) ； 陳立欣(Li-Hsin Chen) ； 凃智文(Chih-Wen Twu) ； 黃弘孟(Hung-Meng Huang) ； 翁詩涵(Shih-Han Weng) ； 徐欣健(Hsin-Chien Hsu)

《台灣耳鼻喉頭頸外科雜誌》 57卷4期 (2022/12) Pp. 256-265

https://doi.org/10.6286/jtohns.202212_57(4).256

摘要

背景：本研究以居家睡眠檢查（home sleep test）來篩檢阻塞型睡眠呼吸中止症（obstructive sleep apnea syndrome, OSAS）高風險族群，目的在於主動走進社區，即早發現與診斷潛在的OSAS患者。方法：本研究為台北市衛生局委台北市立聯合醫院－和平婦幼院區所進行之公衛計畫，收集自2019年7月1日起至2020年6月30日間，經由問卷調查，針對年齡介於30～70歲之OSAS高風險族群，宣導並鼓勵接受可攜式睡眠檢查儀（portable sleep monitor, PM）的檢測。檢測前請受檢者填寫艾普沃斯嗜睡度量表（The Epworth Sleepiness Scale）及睡眠呼吸中止症風險評估問卷（STOP Bang Questionnaire），受檢者於居家穿戴Type3的PM檢測。結果：總篩檢人數為554人，平均年齡49.39±10.90歲，平均身體質量指數（body mass index, BMI）25.91±4.64，平均頸圍37.69±4.51，其中男性301人，平均年齡47.27±10.57歲，女性253人，平均年齡51.92±10.76歲。檢查結果正常173名（29.9%），輕度170名（29.3%），中度101名（17.4%），重度110名（19%）。OSAS患者與正常者比較，年齡上較大，且有顯著差異（p<0.0001），但OSAS患者中，重度患者平均年齡較輕（47.82±10.61），BMI及頸圍，則是依正常、輕度、中度、重度逐漸增加（p<0.0001）。97人後續接受睡眠多項生理檢查（polysomnography; PSG），AHI值分別為5、10、15和30的receiver operating characteristic curve分別為0.778、0.832、0.924和0.989，PSG和AHI之間的組內相關係數（intraclass correlation coefficient）則為0.929，代表AHI值切點越大準確率越高，且PM與PSG相關性與可靠性高。結論：以居家睡眠檢查來篩檢阻塞型睡眠呼吸中止症高風險族群，是一個簡單、快速且有效率的方法，並能即早發現與診斷潛在的OSAS患者。

關鍵字

apnea-hypopnea index ； home sleep test ； obstructive sleep apnea syndrome（呼吸中止或不足指數 ； 居家睡眠檢查 ； 阻塞型睡眠呼吸中止症）

並列摘要

BACKGROUND: This study used a home sleep test to screen for obstructive sleep apnea syndrome (OSAS) in high-risk populations. We aim to enter the community to detect and diagnose potential OSAS patients early. METHODS: This study is a public health project carried out by the Department of Health, Taipei City Government, which appointed the Taipei City Hospital Heping Fuyou Branch. We collected from July 1st, 2019 to June 30th, 2020, through a questionnaire survey targeting high-risk groups of OSAS aged between 30 and 70 years. We publicized and encouraged them to receive the portable sleep monitor (PM) test. Before the test, the subjects were asked to fill in the Epworth Sleepiness Scale (ESS) and the STOP-Bang Questionnaire. The subjects wore a Type 3 PM at home. RESULTS: A total of 554 people were enrolled and completed the home sleep test, with an average age of 49.39 ± 10.90 years, body mass index (BMI) of 25.91 ± 4.64 kg/ m^2, and neck circumference of 37.69 ± 4.51 cm. There were 301 males with an average age of 47.27 ± 10.57 years and 253 females with an average age of 51.92 ± 10.76 years. The results revealed normal in 173 patients (29.9%), mild in 170 patients (29.3%), moderate in 101 patients (17.4%), and severe in 110 patients (19%). Compared with normal patients, OSAS patients were older ( p < 0.0001). However, in the OSAS group, the average age was younger in the severe group (47.82 ± 10.61). The BMI and neck circumference increased gradually based on severity ( p < 0.0001). Ninety-seven people also received a polysomnography (PSG) test. When the AHI values were 5, 10, 15, and 30, the receiver operating characteristic curve was 0.778, 0.832, 0.924, and 0.989, respectively. The intraclass correlation coefficient between PSG and AHI was 0.929, indicating that the larger the AHI value cut-off point, the higher the accuracy, correlation, and reliability between PM and PSG. CONCLUSIONS: Screening high-risk populations of obstructive sleep apnea with a home sleep test is simple, rapid, and efficient. It can detect and diagnose potential OSAS patients early.

並列關鍵字

apnea-hypopnea index ； home sleep test ； obstructive sleep apnea syndrome