Translated Titles

The Related Factors of Sleep Disorder and Sleep Efficacy in the Obstructive Sleep Apnea Patients



Key Words

頸圍 ; 身體質量指數 ; 身體肥胖 ; 睡眠呼吸中止症 ; neck circumstance ; BMI ; sleep apnea syndrome ; body obesity



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Chinese Abstract

中文摘要 睡眠呼吸中止症是近十幾年來最常被醫界用來探討和研究睡眠不足或失眠原因的相關問題。睡眠呼吸中止症患者通常與肥胖有關,亦可能伴有粗短脖子的特徵。相較於身體質量指數(BMI)與體重,頸圍更可反應身體脂肪的累積。本研究根據文獻與臨床症狀,以病患的人口學特質資料為基礎,探討睡眠呼吸中止症的相關因素。 本研究以頸圍、BMI、頸圍/身高、體重等作為衡量身體肥胖的指標,以睡眠呼吸障礙指數、睡眠效能、高血壓、血氧濃度等作為衡量睡眠呼吸中止症特性的指標,探討這些身體肥胖指標與睡眠呼吸中止症特性的相關性。此外,本研究亦以打鼾、呼吸中止以及高血壓的發生與否調整(校正)頸圍,探討調整頸圍和睡眠呼吸障礙指數以及睡眠效能的相關性。本研究的樣本共有107位疑似睡眠呼吸中止症患者,以描述性統計、獨立樣本t檢定、多元迴歸分析等方法進行分析。研究結果發現,年齡較長以及患有高血壓患者的睡眠效能較差;BMI、頸圍、頸圍/身高以及校正後頸圍對睡眠呼吸障礙指數具有正相關;男性以及有抽菸的患者的睡眠呼吸障礙指數較為嚴重。此外,研究結果顯示睡眠呼吸障礙指數較高之患者的血氧濃度較低。 關鍵字:睡眠呼吸中止症、身體肥胖、身體質量指數、頸圍

English Abstract

Abstract In the last decade, sleep apnea syndrome has been widely investigated to study the issues of insomnolence in medical research. Generally, the patients suffering from sleep apnea syndrome share a common feature of “bullneck”. Neck circumstance (NC) can more effectively reflect the accumulation of body obesity when comparing to body mass index (BMI) and body weight (BW). In this research, we study the critical factors of sleep apnea syndrome based on the data of patients’ demographic characteristics. NC, BMI, NC/height, and body weight are used as the metrics of body obesity. Respiratory Disturbance Index (RDI), sleep efficiency, hypertension, and oxygen saturation are applied to represent the characteristics of sleep apnea syndrome. In this research, the relationship of body and the sleep apnea syndrome are investigated. The relationship of demographic characteristics other than body obesity to sleep apnea syndrome is also studied. Moreover, the relationship between the adjusted NC and RDI (or sleep efficiency) is investigated. The research sample includes 107 subjects which are potentially suffering from the sleep apnea syndrome. The descriptive statistics, t test, analysis of variance, and regression analysis are used to analyze the sample data. It is shown from the results of this study that the patients with older age and hypertension have significantly worse sleep efficiency. The higher values of BMI, NC, NC/height, adjusted NC result in significantly higher value of RDI. In addition, higher value of RDI will be accompanied with lower average value of oxygen saturation (or minimum oxygen saturation). Keywords: sleep apnea syndrome, body obesity, BMI, neck circumstance.

Topic Category 理工學院 > 工業工程與管理系
工程學 > 工程學總論
社會科學 > 管理學
  1. 4. 周昆達、吳紹豪、蕭光明,「簡介阻塞型睡眠呼吸中止症」,台北市醫師公會會刊,第五十六卷,第十期,第19-19頁(2012)。
  2. 7. 林思靜,「登階運動訓練對阻塞型睡眠呼吸中止症候群患者心肺耐力與睡眠狀況成效之前驅研究」,長庚大學,桃園(2008)。
  3. 8. 林嘉謨,「睡眠呼吸中止症候群的預測統計模型」,台灣大學,台北(2008)。
  4. 12. 徐逸民,「探討睡眠障礙患者睡眠呼吸中止嚴重度及嗜睡狀態」,亞洲大學,台中(2009)。
  5. 13. 張可臻、陳昭源、林忠順,「淺談阻塞型睡眠呼吸中止症的評估、診斷與治療」,家庭醫學與基層醫療,第二十六卷,第八期,第335頁(2011)。
  6. 14. 郭秋香,「阻塞型睡眠呼吸中止症候群疾病相關因素探討」,長庚大學,台北(2006)。
  7. 15. 陳乃釧、洪宗杰,「阻塞型睡眠呼吸中止症與心血管疾病」,家庭醫學與基層醫療,第二十五卷,第六期,第206-208頁(2010)。
  8. 16. 陳濘宏,「阻塞型睡眠呼吸中止症」,臺灣醫學,第九卷,第三期,第361-366頁(2005)。
  9. 20. 楊家祥、陳俊傑,「阻塞型睡眠呼吸中止症候群的診斷與治療」,基層醫學,第二十一卷,第十一期,第306-311頁(2006)。
  10. 21. 楊啟坤,「台灣地區阻塞型睡眠呼吸中止症病患之臨床預測模式」,亞洲大學,台中(2010)。
  11. 1. American Academy of Sleep Medicine Task Force Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep, 22(5), 667-689 (1999).
  12. 3. Behbehani, K., & Yen, F.C. “Automatic control of airway pressure for treatment of obstructive sleep apnea,” IEEE Transactions on Biomedical Engineering, 42(10), 1007-1016 (1995).
  13. 5. Bresnitz, E.A., Goldberg, R., & Kosinski, R.M. Epidemiology of obstructive sleep apnea. Epidemiologic Review, 16(2), 210-227 (1994).
  14. 6. Davies. R.J., Stradling. J.R. The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome. The European respiratory journal. 3(5), 509-514 (1990).
  15. 7. Flemons, W.W. Clinical practice. Obstructive sleep apnea. The New England Journal of Medicine, 347(7), 498-504 (2002).
  16. 9. Gastaut, H., Tassinari, C.A., & Duron, B. Polygraphic study of the episodic diurnal and nocturnal (hypnic and respiratory) manifestations of the Pickwick syndrome. Brain Research, 1(2), 167-186 (1996).
  17. 10. Hirshkowitz, M. The clinical consequences of obstructive sleep apnea and associated excessive sleepiness. The Journal of Family Practice, 57(8 Suppl), S9-S16 (2008).
  18. 11. Ip, M.S., Lam, B., Lauder, I.J., Tsang, KW., Chung, K.F., Mok, Y.W.,& Lam, W.K. A community study of sleep-disordered breathing in middle-aged Chinese men in Hong Kong. Chest, 119(1), 62-69 (2001).
  19. 12. Ip, M.S., Lam, B., Tang, L.C., Lauder, I.J., Ip, T.Y., & Lam, W.K. A community study of sleep-disordered breathing in middle-aged Chinese women in Hong Kong. Chest, 125(1), 127-134 (2004).
  20. 13. Kawaguchi. Y., Fukumoto. S., Inaba. M., Koyama. H., Shoji. T., Shoji. S., Nishizawa. Y. Different impacts of neck circumference and visceral obesity on the severity of obstructive sleep apnea syndrome. Obesity, 19(2), 276-282 (2011).
  21. 16. Li. K.K., Kushida. C, Powell. N.B., Riley. R.W., Guilleminault. C. Obstructive sleep apnea syndrome: a comparison between Far-East Asian and white men. Laryngoscope; 110, 1689–1693 (2000).
  22. 17. Lin, IF., Chuang, ML., Liao, YF., Chen, Nh., & Li, HY. Predicting Effective Continuous Positive Airway Pressure in Taiwanese Patients with Obstructive Sleep Apnea Syndrome. Journal Formos Medicine Association, 102(4), 215-221 (2003).
  23. 18. Malhotra, A., & White, D.P. Obstructive sleep apnoea. Lancet, 360(9328), 237-245 (2002).
  24. 19. Marshall. N.S., Wong. K.K., Liu. P.Y., Cullen. S.R., Knuiman. M.W., Grunstein. R.R. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep; 31, 1079–1085 (2008).
  25. 23. Netzer, N.C., Hoegel, J.J., Loube, D., Netzer, C.M., Hay, B., Alvarez-Sala, R., & Strohl, K.P. Prevalence of symptoms and risk of sleep apnea in primary care. Chest, 124(4), 1406-1414 (2003).
  26. 24. Onat, A., Hergenç, G., Yüksel, H., Can, G., Ayhan, E., Kaya, Z., & Dursunoğlu, D. Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clinical nutrition, 28(1), 46-51 (2009).
  27. 25. Patil, S.P., Schneider, H., Schwartz, A.R., & Smith, P.L. Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest, 132(1), 325-337 (2007).
  28. 26. Schwartz. A.R., Patil, S.P., Laffan, A.M., Polotsky, V., Schneider, H., Smith, P.L. Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches. Proceedings of the American Thoracic Society, 5(2), 185-192 (2008).
  29. 27. Sharabi, Y., Scope, A., Chorney, N., Grotto, I., & Dagan, Y. Diastolic Blood Pressure Is the First to Rise in Association With Early Subclinical Obstructive Sleep Apnea : Lessons From Periodic Examination Screening. American of Journal Hypertension, 16(3), 236-239 (2003).
  30. 28. Skomro, RP., & Kryger, MH. Clinical Presentions of Obstructive Sleep Apnea Syndrome. Progress in Cardiovascular Disease, 41(5), 331 - 340 (1999).
  31. 29. Strobel, R.J., & Rosen, R.C. Obesity and Weight Loss in Obstructive Sleep Apnea: A Critical Review. Sleep, 19(2), 104-115 (1996).
  32. 32. Udwadia, Z.F., Doshi, A.V., Lonkar, S.G., & Singh, C.I. Prevalence of sleep-disordered breathing and sleep apnea in middle-aged Urban Indian men. American Journal of Respiratory and Critical Care Medicine, 169(2), 168-173 (2004).
  33. 34. Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., & Badr, S. The occurrence of sleep-disordered breathing among middle-aged adults. The New England Journal of Medicine, 328(17), 1230-1235 (1993).
  34. 35. Yaggi, H.K., Concato, J., Kernan, W.N., Lichtman, J.H., Brass, L.M., & Mohsenin, V. Obstructive sleep apnea as a risk factor for stroke and death. The New England Journal of Medicine, 353(19), 2034-2041 (2005).
  35. 36. Young, T., Peppard, P.E., & Gottlieb, D.J. Epidemiology of obstructive sleep apnea: a population health perspective. American journal of respiratory and critical care medicine, 165(9), 1217-1239 (2002).
  36. 參考文獻
  37. 中文文獻
  38. 1. 王元宏,「以心電圖訊號檢測睡眠呼吸中止症的類神經網路」,國立中山大學,高雄(2004)。
  39. 2. 王筱涵,「以血氧飽和濃度檢測睡眠呼吸中止症」,國立中山大學,高雄(2006)。
  40. 3. 石塚洋一著、呂紹鳳譯,「身體危險的信號:打鼾」,台北(2000)。
  41. 5. 林士為,「睡眠呼吸障礙打鼾不僅是惱人的噪音,也可能潛藏健康危機」,長庚醫訊,第23卷,第3期,第17-18頁(2009)。
  42. 6. 林昌宏,「以因素分析進行睡眠呼吸中止症持續性陽壓呼吸治療的壓力預測」,陽明大學,台北(2008)。
  43. 9. 社團法人台灣睡眠障礙協會,「什麼是睡眠呼吸中止症?」http://www.sleep.org.tw/ugC_Term.asp
  44. 11. 孫瑜,「睡眠呼吸中止症與中風」,恩主公醫訊,第4-5頁(2011)。
  45. 17. 陳麗月,「睡眠呼吸中止症病患身心症狀困擾、睡眠品質與相關因素之探討」,國防醫學院,台北(2006)。
  46. 18. 游永惠,「認識阻塞型睡眠呼吸中止症」,恩主公醫訊,第2頁(2011)。
  47. 22. 葉世彬,「睡眠呼吸生理與相關疾病介紹」,台灣醫界,第三卷,第四十八期,第25-30頁(2005)。
  48. 23. 鈴木一郎,「打呼的危險真相」,世茂出版社,台北,第70頁,(2005)。
  49. 24. 廖慧儀,「睡眠呼吸中止症與高血壓之相關性研究-以駕駛為例」,國防醫學院,台北(2008)。
  50. 26. 蔡俊明、蕭光明,「睡眠呼吸中止症候群」,臨床醫學,第十五卷,第五期,第410-419頁(1985)。
  51. 27. 蔡政楒,「你睡的好嗎」,宏欣文化,台北(2005)。
  52. 28. 謝佳宏,「頻譜分析於阻塞型睡眠呼吸中止症之應用」,東華大學,花蓮(2010)。
  53. 29. 謝武峰,「鼾聲隆隆,危機重重─談睡眠呼吸中止症候群」,郭綜合醫院健康資訊(2005)。
  54. 30. 齋藤 恒博,睡得好讓你更健康,商周出版,台北,第19-22頁(2009)。
  55. 英文文獻
  56. 2. Basta, M., Lin, H.M., Pejovic, S., Sarrigiannidis, A., Bixler, E., & Vgontzas, A.N. Lack of regular exercise, depression, and degree of apnea are predictors of excessive daytime sleepiness in patients with sleep apnea: sex differences. Journal of Clinical Sleep Medicine, 4(1), 19-25 (2008).
  57. 4. Bixler, E.O., Vgontzas, A.N., Lin, H.M., Ten, Have, T., Rein, J., Vela-Bueno, A., & Kales, A. Prevalence of sleep-disordered breathing in women: effects of gender. American journal of respiratory and critical care medicine, 163(3 Pt 1), 608-613 (2001).
  58. 8. Ganong, W.F. Alert Behavior, Sleep, and the Electrical Activity of theBrain. In Ganong: Review of Medical Physiology, Twenty- First Edition 195-204 McGraw- Hill (2003).
  59. 14. Katz. I., Stradling. J., Slutsky. A.S., Zamel. N., Hoffstein. V. Do patients with obstructive sleep apnea have thick necks? The American review of respiratory disease. 141, 1228-31 (1990).
  60. 15. Kim, J., In, K., Kim, J., You, S., Kang, K., Shim, J., Lee, S., Lee, J., Lee, S., Park, C., & Shin, C. Prevalence of sleep-disordered breathing in middle-aged Korean men and women. American Journal of Respiratory and Critical Care Medicine, 170(10), 1108-1113 (2004).
  61. 20. Mayo Clinic : http://www.mayoclinic.com/health/medical/IM04014
  62. 21. Mehra, R., Benjamin, E.J., Shahar, E., Gottlieb, D.J., Nawabit, R., Kirchner, H.L., Sahadevan, J., Redline, S. & Sleep Heart Health Study. Association of nocturnal arrhythmias with sleep-disordered breathing: The Sleep Heart Health Study. American journal of respiratory and critical care medicine, 173(8), 910-916 (2006)..
  63. 22. Merritt, S.L., & Berger, B.E. Obstructive sleep apnea-hypopnea syndrome. The American journal of nursing, 104(7), 49-52 (2004).
  64. 30. Sundaram, S., Bridgman, S.A., Lim, J., & Lasserson, T.J. Surgery for obstructive sleep apnoea. The Cochrane database of systematic reviews, (4), CD001004 (2005).
  65. 31. Teculescu, D., Hannhart, B., Aubry, C., Montaut-Verient, B., Virion, J.M., Michaely, J.P., & Gueguen, R. Who are the “occasional” snorers? Chest, 122(2), 562-568 (2002).
  66. 33. Victor, L.D. Obstructive sleep apnea. American family physician, 60(8), 2279-2286 (1999).
  67. 37. Young. T., Shahar. E., Nieto. F.J., Redline. S., Newman. A.B., Gottlieb. D.J., Walsleben. J.A., Finn. L., Enright. P., Samet. J.M.; Sleep Heart Health Study Research Group. Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Archives of internal medicine. 162(8), 893-900 (2002).