选择性睡眠剥夺对健康志愿者睡眠呼吸事件相关指标的影响

Effects of Selective Sleep Deprivation on Related Indexes of Sleep Respiratory Events in Healthy Volunteers

摘要: 目的：探讨选择性睡眠剥夺对健康志愿者再入睡呼吸事件的影响。方法：根据制定的入选和排除标准招募30名健康志愿者(男:女 = 1:1，平均年龄26.27 ± 4.48岁)，随机分为快速眼动睡眠(Rapid-eye-movement, REM)剥夺组和慢波睡眠(Slow-wave-sleep, SWS)剥夺组，两组均接受连续三晚多导睡眠监测(Polysomnography, PSG)，包括基线夜、剥夺夜与睡眠恢复夜。剥夺夜在PSG监测下，当两组出现REM睡眠或SWS睡眠的第一帧多导波形图时，将健康志愿者唤醒，维持3分钟，以保证实现完全的快速眼动或慢波剥夺。记录剥夺前后鼻气流及指端血氧饱和度数据。应用配对t检验或Wilcoxon秩和检验分析探究睡眠剥夺对各指标的影响。结果：在慢波睡眠剥夺前后，呼吸暂停次数(number of apnea, A)差异具有统计学意义(Z = −3.06, P < 0.01)；低通气次数(number of hypopnea, H)差异具有统计学意义(Z = −2.77, P < 0.01)；呼吸暂停低通气次数(apnea hypopnea, A + H)差异具有统计学意义(Z = −3.12, P < 0.01)；呼吸暂停指数(apnea index, AI)差异有统计学意义(t = −3.13, P < 0.01)；呼吸暂停低通气指数(apnea-hypopnea index, AHI)差异有统计学意义(Z = −1.99, P < 0.05)；低通气指数(hypopnea Index, HI)，夜间最低血氧饱和度(lowest SaO₂, LSaO₂)、夜间平均血氧饱和度(mean SaO₂, MSaO₂)无统计学差异(P > 0.05)。快速眼动睡眠剥夺前后呼吸事件无统计学差异(P > 0.05)。结论：慢波睡眠剥夺增加呼吸暂停和低通气事件的发生次数及呼吸暂停低通气指数，而快动眼睡眠剥夺未观察到类似变化。

Abstract: Objectives: To investigate the effect of selective sleep deprivation on respiratory events in healthy volunteers. Methods: According to the selection and exclusion criteria, 30 healthy volunteers (male:female = 1:1, mean age 26.27 ± 4.48 years) were randomly divided into rapid-eye-movement (REM) sleep deprivation group and slow-wave-sleep (SWS) deprivation group. Both groups received polysomnography (PSG) for three consecutive nights, including baseline night, deprivation night and sleep recovery night. With the deprivation night under PSG monitoring, when the healthy vol-unteers were awakened when the first frame of polysomnography of REM sleep or SWS sleep ap-peared in both groups and maintained for 3 minutes to ensure that complete rapid eye movement or slow wave deprivation was achieved. Nasal airflow and finger-end oxygen saturation data were recorded before and after sleep deprivation. Paired t-test or Wilcoxon rank sum test analysis was applied to explore the effect of sleep deprivation on each index. Results: Before and after slow-wave-sleep deprivation, the differences were statistically significant in the number of apnea (A) (Z = −3.06, P < 0.01); the number of hypopnea (H) (Z = −2.77, P < 0.01); the number of apnea hy-popnea (A + H) was statistically significant (Z = −3.12, P < 0.01); apnea index (AI) was statistically significant (t = −3.13, P < 0.01); apnea-hypopnea Index (AHI) was statistically significant (Z = −1.99, P < 0.05), but there were no significant differences in hypopnea index (HI), the lowest SaO₂ (LSaO₂), and the mean SaO₂ (MSaO₂) (P > 0.05). The differences in respiratory events before and after rapid eye movement sleep deprivation were not statistically significant (P > 0.05). Conclusions: Slow-wave-sleep deprivation increased the number of apnea, hypopnea events and apnea-hypopnea index, whereas no similar changes were observed with REM sleep deprivation.